Immediate Versus Delayed Loading of Dental Implants in the Maxillae of Minipigs. Part II: Histomorphometric Analysis
Emeka Nkenke, MD, DDS, PhD/Matthias Fenner, MD, DDS/Eleftherios G. Vairaktaris, MD, DDS, PhD/Friedrich Wilhelm Neukam, MD, DDS, PhD/Martin Radespiel-Troger, MD
Purpose: To assess histomorphometric parameters of dental implants placed in partially edentulous maxillae of minipigs. Materials and Methods: In 9 minipigs, 6 XiVE implants were placed on each side of the maxilla, either after implant site preparation by an osteotome technique or by spiral drills. The implants were restored with fixed provisional restorations and loaded either immediately or after healing periods of up to 5 months. After a loading period of 6 months, the animals were sacrificed and the implants were retrieved together with the adjacent bone. Histologic specimens were prepared and bone-to-implant contact (BIC) ratio, interthread bone area, and peri-implant bone area were determined. Results: An analysis of variance revealed that the BIC ratio on the palatal side was significantly influenced by the preparation technique of the implant site (P = .001) and by the healing period (P = .02). After implant site preparation by an osteotome technique, higher BIC values were achieved for implants that were loaded either immediately or after healing periods of 1 to 3 months. After healing periods of 4 to 5 months, implant site preparation with spiral drills showed slightly better results in regard to BIC. Interthread bone area and peri-implant bone area did not differ significantly statistically for the 2 implant placement techniques and the 3 healing periods. Discussion and Conclusion: After 6 months of functional loading in the maxilla, successful immediately loaded implants performed the same as implants subjected to an unloaded healing period prior to loading as far as histomorphometric data were concerned. Prospective randomized clinical studies should be carried out in humans to compare immediate loading to loading after an unloaded healing phase.
Int J Oral Maxillofac Implants 2005;20:540–546
Key words: delayed loading, histomorphometric analysis, immediate loading, maxilla, osteotome technique