Immediate Loading of the Edentulous Maxilla With a Final Restoration Supported by an Intraoral Welded Titanium Bar: A Case Series of 20 Consecutive Cases

Background: The aim of this prospective study was to evaluate the concept of intraoral welding as a suitable technique for the placement of a final restoration for the edentulous maxilla on the same day as surgery. Methods: Twenty patients with edentulous maxillae received a fixed restoration supported by an intraoral welded titanium bar. Final abutments were connected to the implants and welded to a titanium bar using an intraoral welding unit. This framework was used as a support for the final restoration, which was fitted on the same day as implant placement. Mean marginal bone loss and radiographically detectable alteration of the welded framework were assessed using periapical radiographs immediately after surgery and at 6- and 12-month follow-up examinations. Results: Ten mates and 10 females, with an average age of 51.8 years (SD= 15.1 years; N = 20), were consecutively treated with 153 immediately loaded implants. No fractures or radiographically detectable alterations of the welded framework were evident. All implants osseointegrated and were clinically stable at the time of the 12-month follow-up. Mean marginal bone loss was 0.43 mm (SD = 0.13 mm; N = 153) between 0 and 6 months and 0.14 mm (SD = 0.055 mm; N = 153) between 6 and 12 months. Therefore, the accumulated mean marginal bone loss was 0.57 mm (SD = 0.21 m; N = 153). Conclusions: On the same day of surgery, it is possible to successfully rehabilitate the edentulous maxilla with a fixed, permanent prosthesis supported by an intraoral welded titanium framework. More expanded investigations over longer time periods are required to better determine the long-term success of this approach. J Periodontol 2008;79:2207-2213.