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Volume 25 , Issue 5
September/October 2010

Pages 10111018

Immediate Loading of Fixed Provisional Prostheses Using Four Implants for the Rehabilitation of the Edentulous Arch: A Prospective Clinical Study

Marc Hinze, DMD/Tobias Thalmair, DMD/Wolfgang Bolz, DMD/Hannes Wachtel, DMD, PhD

PMID: 20862417

Purpose: The purpose of this prospective clinical trial was to evaluate over a 5-year period the treatment outcomes for immediately loaded full-arch fixed prostheses supported by two axially inclined and two tilted implants used to rehabilitate edentulous arches. This report presents preliminary 1-year results. Materials and Methods: Thirty-seven patients were recruited for treatment with either mandibular or maxillary full-arch fixed prostheses supported by four implants. Within 24 hours, the implants were immediately loaded with screw-retained full-arch acrylic resin provisional restorations. Definitive reconstructions were delivered 6 months later. Complete full-arch prostheses were supported by metal frameworks combined with high-density acrylic resin. Follow-up visits were scheduled for 6 and 12 months after initial prosthetic loading and then annually for up to 5 years. Digital radiographs were obtained immediately, 6 months after surgery, and at each annual follow-up visit. Marginal peri-implant bone levels were assessed using digital image analysis. Results: The 1-year implant survival rates were 96.0% for axially positioned implants and 94.6% for tilted implants. The survival rates were 96.6% for maxillary implants and 98.7% for mandibular implants. The prosthetic survival rate was 100%. No significant differences were found in the results for tilted versus axially positioned implants. One year after loading, the mean marginal bone loss was 0.82 0.31 mm around the axially oriented implants and 0.76 0.49 mm around the tilted implants (P ≤ .05). Conclusions: Preliminary data from this clinical trial show high implant survival rates for immediately loaded full-arch prostheses supported by four implants. Immediate loading of tilted implants may be considered a viable treatment option for the rehabilitation of edentulous patients. Int J Oral Maxillofac Implants 2010;25:10111018

Key words: dental implants, edentulous jaw, immediate loading, tilted implants

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