Immediate Loading of Four Guided Nonsplinted Implants Supporting a Maxillary Overdenture: A Prospective Clinical...

To evaluate marginal bone level changes and the accuracy of four immediately loaded maxillary implants placed using a flapless guided surgery approach to support a maxillary implant-supported overdenture (ISO) retained with solitary attachments.

Patients with fully edentulous maxillae wearing complete dentures were included. All patients received four endosteal implants placed using a stereolithic, mucosa-supported surgical guide. Implants were immediately loaded following surgery with the maxillary overdenture using a solitary attachment system. Radiographic bone-level change (RBLC) at 12 months after implant placement was the primary outcome variable. Implant survival rate, peri-implant clinical parameters, accuracy of the implant position, prosthetic complications, and patient-centered outcomes were the secondary outcome variables.

A total of 14 patients, accounting for 56 implants, were enrolled in this study. Two implants failed, for a cumulative survival rate of 96.4% at 12 months. The mean RBLC was 0.14 ± 0.36 (range = 0 to 1.7 mm) and 0.31 ± 0.73 mm (range: 0 to 4.45 mm) at 6 and 12 months, respectively. The delta RBLC was statistically significant from baseline (4 weeks postsurgery) to 6 months (P = .005) and from baseline to 12 months (P = .002). The mean global angular deviation was 3.35 ± 1.945 degrees, with a range of 0.00 to 10.3 degrees. The 3D offset at the platform and apex were 0.852 ± 0.483 mm (range: 0.19 to 2.32 mm) and 1.073 ± 0.611 mm (range: 0.26 to 2.65 mm), respectively.

Within the study limitations, our results indicated that four immediately loaded and guided implants supporting a maxillary overdenture with solitary attachments may be a suitable treatment option for the edentulous maxilla.