即時負荷と遅延負荷プロトコルを前歯インプラントに適用した場合の評価
Narahari Ranganatha1, Arvind Kumar Uikey2, Richa Sahai3
1Department of Oral and Maxillofacial Surgery, Rajarajeshwari Dental College and Hospital, Bengaluru, Karnataka, India.
Background:
The timing of prosthetic loading plays a critical role in the long-term success of dental implants. In anterior maxillary regions, both functional and aesthetic outcomes are vital, and clinicians often debate between immediate and delayed loading protocols.
Methods:
A prospective, randomized clinical trial was conducted on 40 patients (20 per group) requiring single anterior maxillary implants. Group A underwent immediate loading within 48 h post-implant placement, while Group B underwent delayed loading after 3 months. Outcomes assessed over 12 months included implant stability (measured by implant stability quotient [ISQ]), marginal bone loss (via cone beam computed tomography), peri-implant soft tissue health, and patient satisfaction (visual analog scale [VAS] scale). Data were analyzed using t-tests and chi-square tests, with P < 0.05 considered significant.
Results:
At 12 months, implant survival was 100% in both groups. Mean marginal bone loss was 0.73 ± 0.22 mm in Group A and 0.69 ± 0.25 mm in Group B (P = 0.54). Mean ISQ at 12 months was 71.6 ± 3.5 (Group A) vs. 72.1 ± 3.2 (Group B) (P = 0.61). Soft tissue indices were comparable. Group A showed significantly higher early patient satisfaction (VAS 9.2 ± 0.8 vs. 7.4 ± 1.1, P < 0.01), though differences were negligible at 12 months.
Conclusion:
Both immediate and delayed loading protocols demonstrated comparable clinical and radiographic outcomes. Immediate loading offers superior early patient satisfaction without compromising implant success, suggesting it as a viable option for anterior single-tooth rehabilitation in suitable cases.
