Immediate Versus Non-immediate Loading Protocols for Reduced-Diameter Implants Supporting Overdentures: A Systematic...

Area of Science:

• Dental Implantology
• Prosthodontics
• Biomaterials Science

Background:

• Reduced-diameter implants (≤ 3.5 mm) are utilized for overdenture retention.
• The timing of prosthetic loading (immediate vs. non-immediate) is a critical factor in implant success.
• Evidence comparing immediate loading (IL) and non-immediate loading (NIL) protocols for these specific implants is needed.

Purpose of the Study:

• To systematically review and compare the clinical outcomes of immediate loading (IL) versus non-immediate loading (NIL) protocols for overdentures supported by reduced-diameter implants (≤ 3.5 mm).

Main Methods:

• A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted.
• Searches were performed in MEDLINE, Embase, and Cochrane Central Register of Controlled Trials.
• Risk of bias and certainty of evidence were assessed using RoB 2.0 and GRADE; sensitivity and subgroup analyses were performed.

Main Results:

• Six RCTs involving 255 patients were included.
• No significant difference in implant survival rates was found between IL and NIL protocols in mini-implant and narrow-diameter implant subgroups, or in short-term and long-term follow-ups.
• Marginal bone loss (MBL) also showed no significant difference in the long-term follow-up subgroup; however, higher plaque index (PI) and probing depth (PD) were noted with IL.

Conclusions:

• The immediate loading (IL) protocol achieves comparable survival rates and marginal bone loss (MBL) to the non-immediate loading (NIL) protocol for reduced-diameter implants supporting overdentures.
• While IL demonstrates similar efficacy in terms of implant stability and bone preservation, clinicians should monitor peri-implant parameters closely due to potentially higher plaque accumulation and probing depths.