Immediate Occlusal Loading of Immediately Placed Implants Supporting Fixed Restorations in Completely Edentulous Arches: A 1-Year Prospective Pilot Study

Background: The aims of this pilot study were to evaluate the efficacy of treatment consisting of the immediate loading of implants placed immediately after tooth extraction in full-arch restorations and to compare the clinical and radiographic outcomes of implants placed in healed versus postextraction sites in the same group of patients. Methods: Twenty-three patients who needed full-arch restorations were treated. One hundred forty-four implants were placed: 59 after tooth extraction (test group) and 85 in healed sites (control group). Within 48 to 72 hours of implant placement, nine maxillary and 15 mandibular arches received screw-retained fixed prostheses, consisting of a titanium framework fabricated with a computer-aided design and manufacturing techniques and composite resin teeth. The insertion torque for implants was >= 30 Ncm. Implant stability measurements (ISQ) and radiographs of the marginal bone level (MBL) change were performed at prosthesis delivery and after 1 year. Results: One implant in the test group and one implant in the control group failed, giving a cumulative success rate of 98.6%; the prosthesis survival rate was 100%. At the 1-year follow-up, no statistically significant difference was found between the control and test sites with respect to MBL change (0.47 +/- 0.18 mm versus 0.57 +/- 0.27 mm) or mean ISQ values (62.24 +/- 1.92 versus 61.34 +/- 2.15). Conclusion: These preliminary data suggest that immediate loading of implants placed immediately after extraction may be a viable treatment option for edentulous arches when implants are stable at insertion and are rigidly splinted with screw-retained titanium-resin prostheses. J Periodontol 2009,80411-421.