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European Journal of Oral Implantology

Editor in Chief: Dr. Marco Esposito

Official publication of the British Society of Oral Implantology (BSOI), Italian Society of Oral Surgery and Implantology (SICOI), Danish Society for Oral Implantology (DSOI), German Association of Oral Implantology (DGI), Spanish Society of Implantology (SEI), British Academy of Implant & Restorative Dentistry (BAIRD) and Advanced Dental Implant Research & Education Center (AIC)

ISSN (print) 1756-2406 • ISSN (online) 1756-2414


Fall 2010
Volume 3 , Issue 3

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A 5-year report from a multicentre randomised clinical trial: immediate non-occlusal versus early loading of dental implants in partially edentulous patients

Capelli, Matteo / Esposito, Marco / Zuffetti, Francesco / Galli, Fabio / Del Fabbro, Massimo / Testroi, Tiziano

Conflict-of-interest statement: This trial was independently designed and initiated by the investigators, however BIOMET 3i provided partial economic support at a later stage.
Purpose: To compare peri-implant bone and soft-tissue levels of immediately non-occlusally loaded versus non-submerged early loaded implants in partially edentulous patients 5 years after implant placement.
Materials and methods: Fifty-two patients were randomised in five Italian private practices: 25 in the immediately loaded group and 27 in the early loaded group. To be immediately loaded, single implants had to be inserted with a torque of > 30 Ncm, and splinted implants with a torque of > 20 Ncm. Immediately loaded implants were provided with non-occluding temporary restorations within 48 hours. After 2 months, the provisional restorations were put in full occlusion. Implants were early loaded after 2 months. Final restorations were provided 8 months after implant placement. Outcome measures were prosthesis and implant failures as well as biological and prosthetic complications recorded by non-blinded assessors. Blinded assessors evaluated peri-implant bone and soft-tissue levels.
Results: Fifty-two implants were immediately loaded and 52 early loaded. One patient of the early loaded group dropped out after the 1-year recall. One single immediately loaded implant failed 2 months after placement. Only one complication (iatrogenic peri-implantitis) occurred in one patient of the early loading group. Both groups gradually lost peri-implant bone in a highly statistically significant way at 2, 8 and 14 months and at 4 and 5 years. After 5 years, patients of both groups had lost an average of 1.2 mm of peri-implant marginal bone. There were no statistically significant differences in peri-implant bone and soft-tissue level changes between the 2 groups. At 5 years, there was a statistically significant recession (0.2 mm) of the vestibular soft tissues from baseline (delivery of the final restorations 8 months after implant placement) only for immediately loaded implants.
Conclusions: In well maintained patients, complications are uncommon and healthy and stable periimplant tissues can be maintained for 5 years around immediately and early loaded implants.

Keywords: dental implants, early loading, follow-up, immediate loading, partial edentulism

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