Twelve-Year Outcomes of Immediately Functionally Loaded Single Implants: A Prospective Multicenter Clinical Study

To evaluate the long-term survival, complications and peri-implant marginal bone loss (PIMBL) associated with immediately functionally loaded single implants after 12 years of follow-up.

Forty-six patients treated at six clinical centers received single implants placed either in healed ridges or fresh extraction sockets and restored under immediate functional loading. All implants were placed according to a standardized surgical and prosthetic protocol and followed for 12 years. Primary outcome measures included implant survival, biologic and prosthetic complications, and PIMBL.

Fifty-seven implants were placed, including 47 in healed sites and 10 in extraction sockets. Six patients (seven implants) were lost to follow-up. After 12 years, only two implant failures were recorded, resulting in survival rates of 95.7% at the patient level and 96.5% at the implant level. Biologic complications occurred in 4.3% of patients and 3.5% of implants, whereas prosthetic complications affected 15.2% of patients and 12.2% of implants. Mean PIMBL at 12 years was 0.41 ± 0.18 mm, with comparable values observed in healed sites and extraction sockets.

Immediate functional loading of single implants demonstrated favorable long-term clinical performance, limited biologic and prosthetic complications, and excellent peri-implant bone stability. When adequate primary stability and appropriate case selection are achieved, this treatment approach appears to be a predictable option for single-tooth rehabilitation.