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Volume 25 , Issue 5
September/October 2010
Pages 1011–1018

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;25:1011–1018

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

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