Immediate Occlusal Loading of Single Lower Molars Using Branemark System® Wide Platform TiUnite™ Implants: A 5-Year Follow-Up Report of a Prospective Clinical Multicenter Study

Introduction: Although not essential, molars hold their importance in terms of functional jaw stability, antagonist opposition, and support of facial height. Therefore, implant therapy is an attractive concept in molar areas. However, especially in the posterior mandible, the conventional two-stage surgical approach to implant therapy was reported to cause higher bone loss and/or higher implant failures with machined implants because of the peculiar anatomic and physiologic conditions of this area. As the TiUnite (TM) (Nobel Biocare AB, GOteborg, Sweden) surface results in faster bone healing than with machined-surface implants, it was hypothesized that this surface would also improve the performance of wide implants in posterior mandibles. Based on these assumptions, a protocol for immediately loaded implants for single molar replacement was developed. Purpose: This paper aimed to report on the clinical and radiological performance of Branemark System(R) TiUnite Wide Platform implants supporting single molars in the lower jaw, loaded immediately and followed for up to 5 years, and to assess if the benefit delivered by oxidized surfaces in the short run is also present after 5 years. Materials and Methods: The study includes 33 consecutive patients treated between March 2001 and September 2003 and monitored until September 2008 in two private dental offices. A total of 40 Branemark System TiUnite Wide Platform MK III implants were placed. All implants were provided with provisional crowns in full centric occlusion at the time of surgery. Patients were clinically and radiologically followed up for up to 5 years. Results: Two implant failed so that the cumulative success rate at 5 years was 95.0%. The mean marginal bone remodeling (n = 38) expressed as mesial plus distal value averages was -1.17 mm (SD +/- 0.90) at the 5-year time point. Conclusion: Although limited by the number of patients treated in accordance with the protocol described, 5-year results encourage the use of immediately loaded single lower molars supported by Branemark System Wide Platform TiUnite implants and further document the clinical advantages of titanium oxidized surfaces.