The radiographic bone loss pattern adjacent to immediately placed, immediately loaded implants

The purpose of this study was to evaluate radiographic bone levels adjacent to implants placed in fresh extraction sockets (ESs) and immediately loaded with a fixed full-arch provisional restoration compared to bone levels adjacent to implants placed in native bone (NB) under the same restorative conditions.

Patients with a hopeless maxillary and/or mandibular dentition had their remaining teeth extracted and 6 to 8 implants placed and restored within 72 hours. Radiographs were obtained at time 0, 3 to 6 months, and annually for 5 years. The radiographs were digitized, and the bone level changes were measured using a computer-assisted method.

A total of 139 implants, 42 ES and 97 NB, placed in 17 patients were evaluated. The overall results indicated that for all implants (ES + NB), 0.60+/-0.71 mm of bone was lost after 6 months; 1.17 +/-0.59 mm of bone was lost after 18 months; 0.87+/-0.76 mm bone was lost after 36 months; and 1.35 +/-0.42 mm of bone was lost after 60 months. When stratifying for NB versus ES implants, it was found that for NB implants, 0.75+/- 0.21 mm of bone was lost after 6 months; 1.31 +/- 0.91 mm of bone was lost after 12 months; 1.07+/-0.21 mm of bone was lost after 36 months; and 1.45 +/- 0.49 mm of bone was lost after 54 months. For ES implants, 0.14 +/-0.33 mm of bone was lost after 6 months; 1.02 +/-0.27 mm of bone was lost after 12 months; 0.86+/-0.42 mm of bone was lost after 36 months; and 1.30 +/-0.48 mm of bone was lost after 54 months.

The combination of ES and NB implants can be immediately loaded with a fixed full-arch prosthesis and remain stable for greater than 5 years. The bone loss adjacent to these implants is similar to that seen surrounding those placed and restored using traditional protocols.