Patient-Reported Outcomes of Immediate Versus Conventional Loading with Fixed Full-Arch Prostheses in the Maxilla: A Nonrandomized Controlled Prospective Study
David Peñarrocha-Oltra, DDS, PhD/Maria Peñarrocha-Diago, MD, DDS, PhD/Luigi Canullo, DDS, PhD/Ugo Covani, MD, PhD/Miguel Peñarrocha, MD, PhD
Purpose: To compare patient satisfaction and postoperative pain and swelling for immediate versus conventional loading in partially edentulous patients requiring extraction of the remaining maxillary dentition and rehabilitation with fixed full-arch prostheses. Materials and Methods: This prospective, controlled, nonrandomized study with 12-month follow-up included 30 consecutive patients scheduled for fixed full-arch implant-supported maxillary rehabilitation. Fifteen patients were treated with conventional loading (control group) and the next 15 with immediate loading (test group). Ten-centimeter visual analog scales were used as assessment tools. Patient overall satisfaction and specific satisfaction with esthetics, chewing, speaking, comfort, self-esteem, ease of cleaning, and treatment duration were assessed preoperatively and at 3 and 12 months postoperatively. Postoperative pain and swelling levels were recorded daily during the first week. Statistical analysis was performed using Mann-Whitney and Wilcoxon rank sum tests, α = .05. Results: One test group patient was excluded, so the final sample included 29 patients. Between baseline and 3 months, in the test group general satisfaction and all specific satisfactions increased significantly with the exception of speech; in the control group overall satisfaction and self-esteem did not change, satisfaction with esthetics increased significantly, and satisfaction with speech, chewing, and comfort decreased significantly. After 12 months, satisfaction was significantly higher in the test group with the exception of ease of cleaning. Between 3 and 12 months, satisfaction improved in both groups but to a greater degree in the control group. After 12 months, there were no differences in satisfaction. No differences were found in either mean postoperative pain/swelling or maximum pain/swelling at the studied time points. Conclusions: Patient satisfaction for immediate loading was significantly higher than for conventional loading during the osseointegration period. After 12 months, when final prosthetic rehabilitations had been in function for some time, differences had disappeared. No differences were found between loading protocols in postoperative pain or swelling.