Interventions for replacing missing teeth: different times for loading dental implants

Area of Science:

• Dental Implantology
• Biomaterials Science
• Prosthodontics

Background:

• Conventionally, osseointegrated dental implants are loaded after a healing period to prevent failure.
• Removable prostheses are uncomfortable for patients during this healing phase.
• Shortening the healing period without compromising implant success is desirable.

Purpose of the Study:

• To evaluate the efficacy of immediate (within 1 week), early (1 week-2 months), and conventional (after 2 months) loading of osseointegrated implants.
• To compare immediate occlusal versus non-occlusal loading during bone healing.

Main Methods:

• Systematic review of randomized controlled trials (RCTs) identified through comprehensive database searches (Cochrane, MEDLINE, EMBASE) and contact with manufacturers.
• Included RCTs focused on root-form osseointegrated implants with 4-month to 1-year follow-up.
• Outcome measures included prosthesis/implant failures and marginal bone level changes.

Main Results:

• Twenty-two RCTs involving 976 participants were analyzed.
• No statistically significant differences in outcomes were found between immediate, early, and conventional loading groups on a per-patient basis.
• One trial compared occlusal versus non-occlusal loading.

Conclusions:

• Immediate or early loading of dental implants is feasible in selected patients, though outcomes may vary.
• Immediate loading (within 1 week) appears potentially more favorable than early loading (1-2 months) to mitigate failure risks.
• High primary implant stability is crucial for successful immediate/early loading; further high-quality RCTs are needed.