Spectrum of indications for palatal implants in treatment concepts involving immediate and conventional loading

To analyze the spectrum of indications for second-generation palatal implants in relation to two different loading concepts in a prospective, multicenter, randomized controlled trial (RCT).

Forty-one patients were recruited to the study from 2006 to 2009. All implants (Orthosystem, Straumann, Basel, Switzerland; dimensions: 4.1 mm x 4.2 mm) were inserted in the median or paramedian region of the anterior palate, and each patient was randomized to one of two loading groups (immediate loading within the first week after insertion versus conventional loading after a 12-week healing phase). In this interim evaluation, we report preliminary results obtained six months after functional loading.

All palatal implants were primarily stable at the time of insertion. One implant loss (12 weeks after surgical insertion) was documented in the cohort subjected to conventional loading, and one patient dropped out of the immediate-loading group. At the time of this investigation, 39 palatal implants are experiencing functional loads. Using both loading concepts, we had various orthodontic objectives, such as intrusion of anterior and/or posterior teeth, and the mesialization and distalization of posterior teeth. Both loading groups presented nearly identical indications, and the distribution of direct vs. indirect anchorage forms was also very similar during the active treatment.

Comparison of the two treatment concepts revealed no clinical differences in implant stability. Patients undergoing immediate-loading therapy were subject to no limitations regarding indications at 6 months after functional loading compared with the patients who experienced conventional loading.