Immediate Functional Loading of Dental Implants Supporting a Bar-Retained Maxillary Overdenture: Preliminary 12-Month Results

Background: The present study evaluated the efficacy of a treatment consisting of placing and immediately loading implants with a bar-retained overdenture in edentulous maxillae. Methods: Twenty-two consecutive patients were treated with four or five implants rigidly connected with a bar, which were then loaded with a maxillary overdenture within 48 hours post-surgery. The patients were followed clinically and radiographically for I year after loading. The implant outcome with regard to survival and success was analyzed. Visual analog scale questionnaires were used to record patient function and satisfaction before and after implant treatment. Results: Of the 103 implants, three failed within I year. Two implants, although integrated, presented with marginal bone resorption (MBR) values higher than those proposed for successful implants. Cumulative survival and success rates of implants were 97.1% and 95.2%, respectively. The average MBR after I year was low (0.78 +/- 0.79 mm). The main prosthetic complication was the frequent need for complete relining of the prosthesis in the initial weeks after loading (27.2%). The questionnaire revealed a significant increase in all comfort, functional, and esthetic parameters (Friedman test; P<0.0001), except in the cleaning feasibility category; a significant decrease in satisfaction was observed in this category (Friedman test; P<0.05), indicating the difficulty patients had in maintaining a high level of oral hygiene. Conclusion: These preliminary results suggest that immediate loading of multiple implants supporting a bar-retained overdenture may represent a predictable treatment option for the rehabilitation of the edentulous maxilla. J Periodontol 2009;80:1883-1893.