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Objectives: The purpose of this clinical study is to compare implant full-arch intraoral scans taken immediately after implant placement with those obtained after tissue healing in patients rehabilitated with implant-supported fixed prostheses. Methods: Between September 2023 and March 2024, a total of 19 patients with compromised residual dentition (6 women; 13 men) were rehabilitated using 4-to-6 immediately loaded post-extraction implants. These implants supported fixed full-arch screw-retained prostheses either in the lower jaw (9 patients) or upper jaw (10 patients). Intraoral scans were taken immediately after implant placement (termed "immediate scan"). After a healing period of four months, the provisional prosthesis was removed, and a second intraoral scan was performed using the same scan bodies and scan pattern as the initial scan (termed "delayed scan"). The two scans were overlaid, and the discrepancies between them were measured. Results: The average discrepancy between the immediate and delayed scans was 0.1905 mm. Our statistical analysis revealed larger discrepancies for implants placed in the posterior areas, with the implant in site 1.6 (Implant 1) showing a discrepancy of 0.2326 mm, and the implant in site 2.6 (Implant 4) showing a discrepancy of 0.2124 mm (p = 0.05). No statistically significant difference was observed when comparing patients treated in the upper and lower jaws. Conclusions: Within the limitations of the study and based on this result, clinicians should be aware that an immediate post-surgical intraoral digital scan for implant-supported full-arch rehabilitations may result in a higher risk of imprecision. Furthermore, according to the results of the study, the accuracy of the digital impression on implant full-arch rehabilitations seems to be influenced by the clinician's skills. Further studies with larger sample sizes are required to confirm our results. [ABSTRACT FROM AUTHOR]

Objectives: To assess the outcome of implant diameter and length on THE distribution of stress using a three-dimensional (3D) finite elements (FE) analysis, with immediate loading implants. Materials and Methods: This study made use of a 3D FE model of an implant encased in a chunk of bone. The LEADER/ITALIA-Fix type implant was created specifically for immediate loading. To create a solid model of the implant and bone and to carry out the FE analysis, the ANSYS V.12 programme was used. Results: The findings indicated that the neck of dental implants is the area of highest stress for all implant diameters and lengths, with an increase in implant length from 10 mm to 12 mm resulting in a slight raise in stress at the interface of implant-bone, and an increase in diameter from 3.75 mm to 4.25 mm having no appreciable impact on the value of stresses around dental implants. Conclusion: It was concluded that an increase in length has a negative effect on stress, while a diameter increase has no discernible impact on stress values. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate radiographic and clinical outcomes of immediate occlusally loaded one-piece zirconia implants after 5 years of follow-up. Materials and Methods: This longitudinal clinical investigation included patients older than 18 years, in need of implant-supported single-unit dental rehabilitations. One-piece zirconia implants were placed in healed and postextraction sites and immediately restored with provisional crowns in light occlusal contact. Definitive zirconia-ceramic restorations were delivered 3 to 4 months after surgery. Primary estimated outcomes were implant survival and success. Periapical radiographs were taken at implant insertion (T0), after 1 year (T1), and after 5 years (T2) to assess marginal bone loss (MBL). Probing depth (PD), modified Bleeding Index (mBI), modified Plaque Index (mPI), and gingival recession (REC) were also measured repeatedly for implants and reference teeth. Changes in parameters over time were assessed using the Wilcoxon signed rank test. In addition, multilevel mixed effects linear and logistic regression models were fitted to take into account within-subject correlations and baseline values. Results: Thirty-two implants were inserted in postextraction and healed sites (n = 16 of each) in 17 patients. One immediate implant was lost after 3 months, and one patient with one implant dropped out after T1. Therefore, the cumulative survival rates were 96.9% at T1 and 96.8% at T2 (4.3 to 6 years). No significant differences were observed in mean MBL between immediate and delayed implants at either T1 or T2. Moreover, different baseline parameters (sex, arch, implant location, smoking habits, grafting) did not show any influence on MBL at either time. In general, for all clinical parameters (PD, mBI, mPI, REC), implants seemed to perform similar to if not better than natural teeth. Conclusion: Radiographic and clinical evaluations after 5 years showed satisfactory amounts of MBL and acceptable soft tissue health. [ABSTRACT FROM AUTHOR]

Objective: To assess clinical survival and success rates of one-piece implants placed at the time of tooth extraction with immediate provisionalization and to evaluate radiographic peri-implant bone loss around one-piece implants 1 year after functional loading. Method and Materials: Forty-six patients (20 men and 26 women) with a mean age of 45.5 years (range, 24 to 74 years) were recruited from four centers for this case series report. Immediately following the extraction of untreatable teeth, all patients received one-piece implants. The implants were immediately restored and placed into function with no occlusal contact. Outcome assessments included clinical and radiographic evaluations. Results: Of the one-piece implants placed after extraction in the maxilla and mandible, 95.7% integrated successfully. The mean marginal bone loss after 1 year was 0.80 mm (SD, 0.53 mm). Overall peri-implant bone loss at maxillary sites was compared with overall bone loss at mandibular sites. At the 1-year follow-up, no statistically significant difference was found. The deeper the implants were placed below the crest, the more marginal bone loss was observed. However, no difference in marginal bone loss was observed as a consequence of the following three variables: implant length (10, 11.5, or 13 mm), implant diameter (3, 3.7, or 4.7 mm); and 3- and 6-month time periods after implant prosthesis placement. Conclusion: Based on data obtained from this sample size study, it can be concluded that one-piece implants can be successfully placed immediately after extraction with minimal peri-implant bone loss. [ABSTRACT FROM AUTHOR]

Purpose: A single-blind randomized controlled split-mouth trial was performed to compare the 36-month outcomes of machined and titanium oxide-anodized (ADZ) dental implant surfaces immediately loaded with fixed partial dentures in the posterior mandible. Materials and Methods: Ten patients with bilateral partial edentulism in the posterior mandible received 42 implants; 20 were placed on the test side (ADZ) and 22 were placed on the control (machined) side. The implants were loaded within 24 hours after placement. Changes in the radiographic bone level (RBL) were measured on standardized periapical films at baseline, 12 months, and 36 months. The mean changes in RBL were compared using a paired t test, and the mean changes in RBL with regard to implant position and implant surface type were compared via two-way analysis of variance. Results: After 36 months of functional loading, the overall cumulative success rate for all implants was 95%. The mean change in RBL at 36 months was 0.35 mm and 0.32 mm for ADZ and machined implants, respectively (not statistically significantly different between groups; P = .88). A reduction in RBL was observed for both machined and ADZ implants between 12 and 36 months, but only the machined implants demonstrated a statistically significant decrease in RBL during the observation period. Conclusions: No statistically significant differences in RBL change were found between machined and ADZ implant surfaces after 36 months in function, and both surfaces demonstrated minimal marginal bone remodeling. As such, immediate loading of ADZ and machined dental implants supporting fixed partial dentures may be a suitable long-term treatment option in the posterior mandible. [ABSTRACT FROM AUTHOR]

Purpose: Immediate loading has become an emerging technique because it has been shown to be asuccessful, time-saving procedure. Recently, immediate loading has been performed simultaneously with implant placement into fresh extraction sockets; excellent results have been achieved, but few reports are available with a long-term follow-up. The aim of the present study was to evaluate the difference in success rates in the maxilla between postextraction implants and implants placed in healed sites, both of which were immediately loaded, after a long-term follow-up. Materials and Methods: Between October 2001 and February 2003, 239 implants were inserted in 81 consecutively operated patients and immediately loaded; 138 implants were placed in fresh postextraction sites (57.7%) and 101 implants were placed in healed sites (42.3%). Two different implant systems were used in this study. Each implant was loaded within 72 hours of placement (60.3% at the time of surgery, 6.3% after 24 hours, 30.1% after 48 hours, and 3.3% after 72 hours). Preestablished success criteria were used to evaluate the success rate of the implants. Results: The mean follow-up was 6.7 years (range: 6.0 to 7.3 years). Only 8 of the 239 implants failed, for an overall success rate of 96.6%. Six of the failed implants were inserted in postextraction sites, and 2 had been placed in healed sites; the success rates were 95.7% and 98.0%, respectively. Statistical analysis revealed no significant differences between postextraction and healed sites. Conclusions: Immediate loading of immediate postextraction sites results in an implant success rate that is broadly comparable to that seen for implants placed in healed sites. Moreover, this procedure can provide predictable and favorable results in many different clinical conditions and for a long term. [ABSTRACT FROM AUTHOR]

Objective: The aim of this prospective study was to assess the outcomes of an implant maintenance protocol for implants supporting a full-arch rehabilitation. Materials and methods: Sixtyone patients (28 women and 33 men) treated with immediately loaded full-arch rehabilitation, both mandibular and maxillary, supported by a combination of two tilted and two axial implants, were included in the study. Patients were scheduled for follow-up visits every 6 months for +2 years, then yearly up to 4 years. Each patient received professional oral hygiene treatment and detailed oral hygiene instructions. During each visit, modified plaque index, bleeding index and probing depth were assessed. The presence of peri-implant tissue inflammation was also evaluated. Results: Mean observation time, considering both mandible and maxilla, was 18.3 months ranging from 6 months to 5 years. Both plaque and bleeding indexes frequency decreased over time. Probing depth was stable (2.46 ± 0.5 mm at 4 years). Only three implants were lost due to periimplantitis (1.4% at 12 months), whereas the incidence of peri-implant mucositis was less than 10% in each considered period. Conclusions: The adoption of a systematic hygienic protocol is effective in keeping low the incidence of peri-implant mucositis as well as in controlling plaque accumulation and clinical attachment loss. [ABSTRACT FROM AUTHOR]

Background: Guided implant surgery is considered as a safe and minimally invasive flapless procedure. However, flapless guided surgery, implant placement in post-extraction sockets and immediate loading of complete-arch fixed reconstructions without artificial gum are still not throughly evaluated. The aim of the present retrospective clinical study was to document the survival and success of complete-arch fixed reconstructions without artificial gum, obtained by means of guided surgery and immediate loading of implants placed also in fresh extraction sockets., Methods: A total of 12 patients (5 males and 7 females, with a mean age of 50.0 ± 13.8) were enrolled in this study. Implant planning was performed with a guided surgery system (RealGuide®, 3Diemme, Como, Italy), from which 3D-printed surgical templates were fabricated. All implants (Esthetic Line-EL®, C-Tech, Bologna, Italy) were placed through the guides and immediately loaded by means of a temporary fixed full-arch restoration without any artificial gum; the outcome measures were implant stability at placement, implant survival, complications, prosthetic success, soft-tissue stability, and patient satisfaction., Results: One hundred ten implants (65 of them post-extractive) were placed flapless through a guided surgery procedure and then immediately loaded by means of provisional fixed full arches. Successful implant stability at placement was achieved in all cases. After a provisionalization period of 6 months, 72 fixed prosthetic restorations were delivered. Only 2 implants failed to osseointegrate and had to be removed, in one patient, giving a 1-year implant survival rate of 98.2% (108/110 surviving implants); 8/12 prostheses did not undergo any failure or complication during the entire follow-up period. At the 1-year follow-up control, soft-tissue was stable in all patients and showed satesfactory aesthetic results., Conclusions: Within the limits of this study, complete-arch fixed reconstruction by means of guided surgery and immediate loading of implants placed in fresh extraction sockets appears to be a reliable and successful procedure. Further long-term prospective studies on a larger sample of patients are needed to confirm these positive outcomes.