Immediate Loading of Dental Implants in the Completely Edentulous Maxilla: A Clinical Report
Robert A. Jaffin, DMD/Akshay Kumar, DMD/Charles L. Berman, DDS
Purpose: The purpose of this article was to determine whether clinical success can be achieved with immediate loading in the completely edentulous maxilla with endosseous screw-type implants. Materials and Methods: The study sample consisted of 34 patients who were edentulous or about to lose all remaining maxillary teeth. The patients underwent an extensive presurgical and prosthetic workup to determine whether they qualified for the study. Sufficient osseous structure to place 6 to 8 implants with a minimum length of 8 mm was required. Provisional prostheses were fabricated either chairside on the day of implant placement or in a laboratory from an impression. The abutments and temporary restorations were placed 48 to 72 hours postsurgery. Results: A total of 236 implants were placed in 34 patients. Sixteen implants were lost in 11 patients; thus the survival rate was 93%. All patients subsequently received definitive maxillary restorations. Discussion: The major cause of implant failure appeared to be micromotion during healing. This was the result of either a non–passively fitting restoration or noncompliance (eg, eating chewing hard foods before the implants had integrated). Conclusions: This clinical report suggests that immediate loading of implant-supported restorations in the completely edentulous maxilla was a viable treatment alternative for this patient population.