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This study aimed to compare implant stabilities between the immediate and early loaded, immediately placed bone‐level tapered dental implants in the maxilla and to evaluate marginal bone loss (MBL), oral health‐related quality of life (OHRQoL), and patient satisfaction at a 2‐year follow‐up. A pilot, prospective, randomized, controlled clinical trial was conducted on 24 maxillary failing dentition patients. The bone‐level tapered implants of 12 patients were immediately loaded with temporary restorations, while the other 12 patients did not receive any kind of temporization. Implant‐supported screw‐retained complete porcelain‐fused‐to‐metal prostheses were delivered to all patients in the seventh postoperative week. The insertion torque values of implants assigned to the immediate and early loading groups were 33.0 ± 4.87 and 29.26 ± 8.31 Ncm, respectively. The dynamics of implant stability changes from implant placement up to a 2‐year follow‐up were similar for both groups (Penguin®, p = 0.268; Ostell®, p = 0.552), while the MBL was at submillimeter level. The cumulative implant survival rate was 91.80% for immediately loaded implants and 97.22% for early loaded implants, without significant difference (p = 0.162). The total score on the Oral Health Impact Profile questionnaire significantly decreased over time in both groups, indicating improvement in OHRQoL (p < 0.001), and the high level of patient satisfaction remained after 2 years of function regardless of a loading protocol. Both loading protocols, immediate and early, of six immediately placed bone‐level tapered dental implants are an adequate treatment choice for fixed rehabilitation of the maxillary failing dentition. [ABSTRACT FROM AUTHOR]

Objective: To assess the clinical outcomes by means of implant and prosthetic survival of late placed and early loaded implants with a hydrophilic, moderately rough surface for partially edentulous patients after a follow‐up of 8.5 to 9.5 years. Materials and methods: A prospective case series study involving 15 patients with single, late placed and early loaded implants in the posterior mandible was performed. Clinical and radiographical parameters, including biological and technical complications and patient satisfaction, were assessed. Results: From an initial sample of 15 patients, 12 were included. A total of 16 implants were observed. After a mean follow‐up of 9 years and 7 months (SD ± 3.8 months), implant success and survival rate were 100%. The prosthetic survival rate was 100%, and the prosthetic success rate was 93.8% since a major chipping was observed. No biological complications were observed, and the mean modified plaque index was 0.03 (SD ± 0.09) with a mean probing pocket depth of 2.95 mm (SD ± 0.09). A mean marginal bone level (MBL) of 0.04 mm (SD ± 0.88) and a mean VAS of 9.42 (SD ± 0.90) for patient satisfaction were recorded. Conclusion: Late placed and early loaded implants with a moderately rough endosseal surface are a reliable option for rehabilitating partially edentulous patients. An implant survival rate of 100% and a prosthodontic success rate of 93.8% were observed. Patient satisfaction scores were high and peri‐implant hard and soft tissues remained healthy. The study findings should be carefully interpreted because of the small sample. [ABSTRACT FROM AUTHOR]

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Objectives: The aim of this retrospective study was to evaluate the effect of vertical soft tissue thickness (STT) on crestal bone loss (CBL) of early loaded implants after 1 and 5 years. Method and materials: Forty-four tapered implants with platform switching and conical connection were placed in the posterior mandible and maxilla to rehabilitate edentulous sites. STT at implant sites was divided into two groups: thin (n = 21, mean STT = 2.0 ± 0.3 mm) and thick (n = 23, mean STT = 3.0 ± 0.8 mm). The implants were loaded after 6 to 8 weeks. Survival and success rates and CBL were measured after 1 and 5 years. Results: The survival and success rates at 1 and 5 years were 100% and 97.8%, respectively. At the 1-year follow-up, the CBL of the thin and thick gingival groups was 0.96 ± 0.49 and 0.55 ± 0.41 mm, respectively; the difference was statistically significant (P = .004). At 5 years, the CBL of the thin and thick gingiva groups increased to 1.12 ± 0.84 and 0.65 ± 0.69 mm, respectively; the difference was not statistically significant (P = .052). Conclusion: At 1 year, the CBL was more pronounced at sites with a thin gingiva; at 5 years the difference between the groups was not statisically significantly different. Within the limitations of this study, early loading of implants with platform switched and conical connection was safe. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the 5-year results of the clinical and radiographic outcomes of three types of early loaded implants. Materials and Methods: Seventy-five implants were placed in the posterior mandible or maxilla in 30 patients. Three types of implants (Straumann SLActive, Astra OsseoSpeed, and Thommen Implant System) were used. Definitive restorations were made after 8 weeks of implant placement. The radiographs were taken at the placement of the prosthesis, at 6 months, and at 1- and 5-year follow-ups. Clinical and radiologic data were evaluated for all types of implants. The Wilcoxon signed rank test, least significant differences, and Mann-Whitney U were used to test for statistically significant differences (P < .005). Results: Twenty-four patients and 62 implants were evaluated after 5 years. The mean marginal bone loss was 0.20 ± 0.40 mm, 0.21 ± 0.05 mm, and 0.25 ± 0.36 mm after 1 year and 0.32 ± 0.22 mm, 0.31 ± 0.26 mm, and 0.42 ± 0.36 mm after 5 years for the Straumann, Astra, and Thommen groups, respectively. After 5 years, the mean peri-implant probing depth level was 1.75 ± 0.49 mm, 1.87 ± 0.48 mm, and 1.92 ± 0.57 mm for the Straumann, Astra, and Thommen groups, respectively. No peri-implantitis was detected after 5 years of loading. Conclusion: All groups of implants showed a stable peri-implant probing depth and marginal bone level. The survival rate was high and bone loss was low at 5 years; thus, early loading may be a useful procedure that allows reduction in treatment time. [ABSTRACT FROM AUTHOR]

Purpose: The hydrophilic implant surface (INICELL) is a chemical alteration of a sandblasted and thermally acid-etched surface that should lead to long-term osseointegration. This study investigated 3-year results after early loading of implants with a hydrophilic, moderately rough surface in occlusal contact. Materials and Methods: This prospective case series study was conducted in subjects with partially edentulous mandibles. Implants were placed on day 21 and loaded with a provisional reconstruction after at least 21 days of healing (baseline, day 0) if their implant stability quotient (ISQ) was ≥ 70 (mean of three measurements) and were replaced by definitive porcelain-fused-to-metal prostheses at the 6-month follow-up visit. Follow-up examinations were planned 1, 3, 6, 12, and 36 months after baseline. Results: A total of 20 implants were placed in 15 patients (mean age: 51 years, range: 32 to 67 years). After 36 months, all implants were osseointegrated, and no suppuration was recorded. Small changes of bone level were observed between 3 months and 36 months. At 36 months, the median values of the 20 implants were 0.25 (range: 0 to 0.5, SD: 0.17), 0.25 (range: 0 to 1, SD: 0.27), and 4 (range: 2 to 7.25, SD: 1.17) for the mean modified Plaque Index (mPI), mean modified Sulcus Bleeding Index (mSBI), and mean probing pocket depth, respectively. The pairwise analysis between 3 and 36 months showed an improvement in the mean mPI (P = .0126) and mean mSBI (P = .0059). After 36 months, all patients (n = 15) were fully satisfied with a mean of 9.43 (range: 8 to 10, SD: 0.678) at the visual analog scale. Conclusion: Early functional loading of implants with a hydrophilic, moderately rough outer surface in occlusal contact 21 days after healing appears to be a safe and feasible treatment option when placed in the posterior mandible of partially edentulous patients. [ABSTRACT FROM AUTHOR]

The article provides an overview of the existing methods of early loading of monolithic structures. It is shown that keeping concrete up to standard strength without taking into account the stages of loading leads to a significant increase in the cost of work, especially in winter. Based on experimental studies, formulas are proposed for calculating the required strength by the moment of loading of monolithic foundations, walls, columns, ceilings. Instructions are given on the design of early loading technology. The results of full-scale tests of floors under conditions of early loading are given. The technology of tiered heat treatment of monolithic structures is described.

Background: This study aims to show the clinical outcomes of implants supporting mandibular overdentures in edentulous patients. Methods: Mandibular edentulous patients were diagnosed with an oral examination, panoramic radiograph, and diagnostic casts for intermaxillary relations and treated with overdentures over two implants. After two-stage surgery, implants were early loaded with an overdenture at 6 weeks. Results: Fifty-four patients (28 females and 24 males) were treated with 108 implants. Thirty-two patients (59.2%) had a previous history of periodontitis. Twenty-three patients (46%) were smokers. Forty patients (74.1%) suffered from systemic diseases (i.e., diabetes, cardiovascular diseases). The clinical follow-up of the study was 147.8 ± 10.4 months. The clinical outcomes showed a global success of 94.5% of implants. Fifty-four overdentures were placed in the patients over the implants. The mean marginal bone loss was 1.12 ± 0.34 mm. Nineteen patients (35.2%) showed some kind of mechanical prosthodontic complication. Sixteen implants (14.8%) were associated with peri-implantitis. Conclusions: Based on the clinical results obtained, we can determine that the treatment of elderly edentulous patients with mandibular overdentures through the early loading of two placed implants is a successful implant protocol. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate long-term outcomes in a 10-year follow-up study of patients who previously completed a 3-year multicenter randomized controlled trial of immediate and early loading of dental implants with a hydrophilic and chemically active surface (SLActive) in the posterior maxilla or mandible. The patients received implants to replace at least one missing tooth, with provisional restoration on the day of surgery (immediate loading) or 28 to 34 days later (early loading). Implant survival, change in crestal bone level, and patient satisfaction were evaluated. In total, 56 patients (with 72 implants) were available after 10 years and fulfilled the criteria for the radiographic bone level evaluation. The mean crestal bone level change from implant surgery to 10 years was -2.00 ± 1.19 mm and -1.37 ± 1.06 mm in the immediate and early groups, respectively. The corresponding change between 5 to 6 months' post-surgery (permanent fixed restoration placement) and 10 years was -1.25 ± 0.99 mm and -0.89 ± 1.11 mm in the immediate and early groups. After the initial remodeling phase (5 to 6 months) where the depth of implant placement had an influence on the initial bone remodeling, no significant differences between the two treatment groups were detected. Mean implant survival was 97.6% (98.2% and 97.1% in the immediate and early loading groups, respectively). Implants with the SLActive surface show successful long-term outcomes following immediate or early loading in posterior maxillae and mandibles. [ABSTRACT FROM AUTHOR]

The study evaluated the implant bone loss and stability of implant changes with diverse designs with early placement at eight weeks and eight months' time. The subjects for the current study had partial tooth loss in the posterior mandibular arch. A total of 30 samples were split into two groups of 15, one with a flared crest module and a buttress thread design, the other with a parallel crest module and a V-shaped thread design. Ostell assessed each subject's implant stability four times, at baseline, eight weeks, four months, and eight months. At intervals of eight weeks, four months, and eight months, intraoral periapical radiographs were examined using ImageJ software to measure crestal bone loss. When Group I and Group II's implant stability quotient (ISQ) values at baseline, eight weeks, four months, and eight months were compared; Group I's ISQ values at each of the four measured time periods were statistically significant. At eight weeks in Group I, the ISQ value was very considerable. At eight weeks, four months, and eight months, there was a statistically significant bone loss in Group II in comparison to Group I. At eight months, Group II's bone loss value was very considerable. In contrast to Group II implant designs, it was found that Group I implants demonstrated enhanced implant-less bone loss and stability.

Aim: The goal of this study was to evaluate how early loading of dental implants, both functional and non‐functional, can affect the stability of the implants, marginal bone resorption after 1 year of follow‐up. Material and Methods: The research sample consisted of 24 implants placed on patients aged between 21 and 62 years (the mean age 51 years). Implants were placed at one surgical stage in the posterior area of the mandible. Then implants were loaded early after 6 weeks of implantation. The sample was divided randomly into two equal main groups according to loading types, 12 implants in the early functional loading (EFL) group and 12 implants in the early non‐functional loading (ENFL) group. The implant stability quotient was registered using Osstell Mentor at the implant placement procedure and after 6 and 12 weeks. The mean marginal bone loss around the implants was measured using the periapical radiographs after 3 and 12 months. The mean values were calculated and statistically analysed using the two‐sample t‐test with 95%confidenence interval p < 0.05). Result: The mean values of implant stability quotient (ISQ) were 72.91–73.87–76.75 in the EFL and 71.91–73.91–76.66 in the ENFL, at the implant placement procedure and 6, 12 weeks respectively. There was no statistically significant difference (p < 0.05) between the two groups. At the 12‐month post‐loading follow‐up, the mean marginal bone loss was 0.698 for the EFL group and 0.683 for the ENFL group. There was no statistically significant difference (p < 0.05) between the two groups. The implant survival rate was 100% in both groups, and there was no complication during the follow‐up period. Conclusions: This study showed that there is no difference in the implant stability quotient (ISQ) and bone loss between the early functional loading group and the early non‐functional loading group. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the long-term effectiveness of 6.6 mm long flapless-placed single implants loaded immediately or early loaded at 6 weeks. Materials and methods: Thirty patients each received two single Nanotite External Hex Biomet 3i implants, which were then randomly allocated to be either immediately or early loaded, according to a split-mouth design. Implants had to be inserted with a torque superior to 40 Ncm. Provisional crowns were put in slight occlusal contact and replaced by definitive crowns 3 months after loading. Patients were followed for 9 years after loading. Outcome measures were implant failures, biological and biomechanical complications, peri-implant marginal bone level changes and patient preference. Results: A total of 29 implants were immediately loaded, while 31 were early loaded. Nine years after loading, three patients dropped out. One implant failed in each group within 2 months after loading. One patient asked for the immediately loaded crown to be remade for aesthetic reasons and then again to have both metal-ceramic crowns replaced by full ceramic crowns. Another patient had his immediately loaded crown remade after repeated debonding. Six patients from each group experienced complications, the difference being not statistically significant (difference of proportions = 0.00; 95% CI -0.20 to 0.20, P = 1.000). Peri-implant bone loss was 0.60 mm for patients with immediately loaded implants and 0.46 mm for early loaded ones, which was not significantly different (mean difference = 0.14 mm, 95% CI -0.13 to 0.41, P = 0.283). All but one patient had no preference for either procedure after 9 years. Conclusions: Flapless-placed 6.6 mm long single implants can be immediately loaded and remain successful up to 9 years after loading. [ABSTRACT FROM AUTHOR]

The article provides information on randomized controlled trials on Osseointegrated dental implants with implant survival rates on the basis of immediately (Within 48 hours), early (at 6 weeks) and conventionally. Topics discussed includes dental implant, Scar tissues and Prosthesis failure in dental implant.

Introduction: Osseointegration is considered one of the most important deciding factors to check for implant stability, which decides successful outcome of the implant. Photobiomodulation has been used to improve the implant stability by enhancing osseointegration. Photobiomodulation (PBM) or Low-level Laser Therapy (LLLT) causes an enhanced effect in the bone implant contact. Need for the Study: There are no definitive therapies/protocol of LLLT in cases of bone density of D3 and D4. Also There are no studies in literature which compares the different laser settings so that a standardised setting can be established. Therefore, there is need to generate evidence whether reducing the number of appointments and reducing the amount of energy given in D3 and D4(compromised) bone can help achieve early loading in patients. Aim: To evaluate and compare the effect of three different photobiomodulation therapies on primary and secondary implant stability in D3 and D4 bone type in comparison to control group to achieve early loading. Materials and Methods: This randomized controlled, double blinded study allocated 108 patients having D3 or D4 bone according to Misch classification into six groups. Three different PBM therapy which is either Therapy A, B or C(placebo) will be used. The implant stability will be measured by Ostell meter in Implant Stability Quotients (ISQ) scale, immediately after surgery, after 3 weeks, after 12 weeks and after 6 months of surgery. The bone density will be measured before surgery and 3 months after surgery. Expected Outcome: At the end of the study, an evidence will be generated whether reducing the number of appointments and reducing the amount of energy given in D3 and D4(compromised) bone can help achieve early loading in patients. Patients treated using PBM therapy either protocol A or protocol B may show enhanced implant stability.

The study evaluated the implant bone loss and stability of implant changes with diverse designs with early placement at eight weeks and eight months' time. The subjects for the current study had partial tooth loss in the posterior mandibular arch. A total of 30 samples were split into two groups of 15, one with a flared crest module and a buttress thread design, the other with a parallel crest module and a V-shaped thread design. Ostell assessed each subject's implant stability four times, at baseline, eight weeks, four months, and eight months. At intervals of eight weeks, four months, and eight months, intraoral periapical radiographs were examined using ImageJ software to measure crestal bone loss. When Group I and Group II's implant stability quotient (ISQ) values at baseline, eight weeks, four months, and eight months were compared; Group I's ISQ values at each of the four measured time periods were statistically significant. At eight weeks in Group I, the ISQ value was very considerable. At eight weeks, four months, and eight months, there was a statistically significant bone loss in Group II in comparison to Group I. At eight months, Group II's bone loss value was very considerable. In contrast to Group II implant designs, it was found that Group I implants demonstrated enhanced implant-less bone loss and stability. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate clinical safety and effectiveness of a novel calcium-incorporated titanium implant (Xpeed, MegaGen Implant Co. Limited, Gyeongbuk, South Korea). Materials and methods: In total, 60 patients were randomised to receive one to six titanium implants in the maxilla with either calcium-incorporated (Xpeed) or control resorbable blasted media (RBM) surfaces, according to a parallel group design at two centres. Implants were submerged and exposed at three different endpoints in equal groups of 20 patients at 12, 10 and 8 weeks, respectively. Within 2 weeks, implants were functionally loaded with provisional or definitive prostheses. Outcome measures were prosthesis failures, implant failures, any complications and peri-implant marginal bone level changes. Results: A total of 30 patients received 45 calcium-incorporated implants and 30 patients were given 42 control titanium implants. Five years after loading, eight patients dropped-out from the Xpeed group and nine left the RBM group. No prosthesis or implant failures occurred. Two patients were affected by three complications in the Xpeed group vs five patients from the RBM group, who experienced eight complications; the difference between groups being not statistically significant different (P = 0.187; difference in proportions = 14.7%; 95% CI: -10.7% to 39.4%). Five years after loading patients with Xpeed implants lost on average 1.19 ± 0.48 mm of peri-implant marginal bone vs 1.43 ± 0.98 mm of patients with RBM implants, the difference being not statistically significant (P = 0.35; mean difference: -0.23 mm; 95% CI: -0.73 to 0.27 mm). Conclusions: Both implant surfaces provided good clinical results and no significant difference was found when comparing titanium implants with a nanostructured calcium-incorporated surface with implants with an RBM surface. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the clinical and radiographic outcomes of 6‐mm short implants, placed in the posterior jaws and supporting splinted crowns, at 5 years after early loading. Materials and Methods: Forty‐five patients with 95 implants (diameter: 4 mm; length: 6 mm) were enrolled at three centres. Two to three implants were placed in either the maxillary or the mandibular posterior region in each patient and restored with screw‐retained splinted crowns at 6 weeks later. Clinical and radiographic outcomes were evaluated at implant placement, at loading, and at 6, 12, 24, 36, and 60 months after loading. Biological and mechanical complications were recorded. Marginal changes in bone level in relation to clinical parameters were evaluated using a generalized linear mixed model. Results: During the 5 years of follow‐up, the mean change in the marginal bone level (MBL) was 0.04 ± 0.14 mm. Four implants in four patients were lost before loading, one implant in one patient was lost at the 5‐year follow‐up, and two patients were lost to follow‐up. The survival and success rates were 88.4% (38/43) at the patient level. The incidence rates of peri‐implant mucositis and peri‐implantitis were 29.4% and 7.0%, respectively. The rate of technical complications was 14.0%. Conclusions: Over a 5‐year period, 6‐mm short implants supporting early loaded splinted crowns in maxillary or mandibular posterior regions showed stable MBLs and acceptable technical and biological complication rates. [ABSTRACT FROM AUTHOR]

Abstract Background Various surface treatment options have been adopted with the aim to improve osseointegration, reducing the overall treatment time. Implant stability of early loaded implants with different modified surfaces was compared in the present study. Methods Patients were selected from the Department of Oro-Maxillofacial Surgery and Stomatology at Semmelweis University. Patients randomly received SA (alumina sandblasted and acid-etched), NH (bioabsorbable apatite nanocoating) or SLA (large-grit sandblasted and acid-etched) surface implants. Outcome measures were: implant success, implant stability, and periodontal parameters. The implant stability was measured at the time of implant placement (primary stability) and six weeks after (prothesis delivery, secondary stability). Osstell and Periotest were applied to take all the measurements. The primary and secondary stability were compared in the three study groups Finally the periimplant probing depth appearing after three months of loading was checked on 6 points around to the implant-supported prostheses. Shapiro–Wilk and Mann–Whitney tests were used for the comparison between the study groups. Results A total of 75 implants with different length and diameter were inserted into various positions. One implant failed spontaneously at the fourth week after implant placement. The survival rate was 98,7%. Comparing the primary and secondary stability values, the data were significantly improved in every groups. The difference was the highest in the NH group, however, this difference was not significant compared to the two other groups. Good periodontal parameters were experienced in all the tested implants, independently by the groups. Conclusions With the limitation of the present study, all the implants showed improved stability six weeks after implant placement. A trend of higher result was found for the NH group. Further studies with longer follow-up are needed to confirm this preliminary results. Trial registration: Current Controlled Trials ISRCTN13181677; the date of registration: 04/03/2021. Retrospectively registered.

Aims: The study compared changes in implant stability and bone loss of implants with different designs using early loading at 6 weeks. Setting and Design: In vivo-comparative study. Materials and Methods: Forty subjects were selected and divided randomly by sealed envelope method in Group X and Group A for early loading for missing single posterior tooth in mandible. Implants in Group X had flared crest module and buttress thread design, whereas implants in Group A had parallel crest module and V-shaped thread design. All subjects were evaluated by Ostell for implant stability at the interval of baseline, 6 weeks, 3 months, and 6 months. ImageJ software was used for measurement of crestal bone loss in intraoral periapical radiographs at the interval of 6 weeks, 3 months, and 6 months. Statistical Analysis Used: Unpaired t test, repeated ANOVA, Tukey post hoc test. Results: The mean bone loss values of Group X at predetermined interval were 1.51 ± 0.20 mm, 2.11 ± 0.21 mm and 2.13 ± 0.21 mm. The mean bone loss values of Group A were 1.79 ± 0.16 mm, 2.92 ± 0.23 mm and 2.95 ± 0.23 mm. The mean bone loss was statistical significant (P < 0.05) at 6 weeks, 3 months and 6 months. It was highly significant in Group A at 6 months (P < 0.001). Conclusions: It was concluded that Group X implants design showed better implant stability and less bone loss when compared to Group A implants design.

Purpose: The purpose was to evaluate the difference in crestal bone loss (CBL) around implants with flap and flapless methods followed by early loading. Materials and Methods: Twenty implants were placed in twenty patients – ten using flap and ten using flapless techniques. The difference in CBL was measured on standardized digital periapical radiograph taken at 0 week, 6 weeks, 12 weeks, and 6 months. Results: The present study showed the mean CBL on proximal surfaces when evaluated at intervals of 0 week, 6 weeks, 12 weeks, and 6 months for flapless method was significantly lower than with flap method the values of which were +0.07 mm against +0.26 mm on mesial side and +0.15 mm against +0.33 mm on distal side at 6 months. Conclusion: The flapless approach is a predictable procedure when patient selection and surgical technique are appropriate, and results in lesser CBL.

Achieving success in dental implant therapy within the esthetic zone involves not only ensuring that the implant properly integrates with the surrounding bone but also achieving a visually pleasing outcome. It is challenging to create a seamless and balanced appearance of the gums around the implant, in harmony with the natural teeth nearby. To replace a missing tooth in the esthetic zone, immediate implant placement and provisionalization, a meticulously researched and dependable method, have received recognition as a predictable technique demanding fewer surgical procedures. This case report demonstrates how to replace failing upper central and lateral incisors while maintaining the gum esthetics by using immediate implant placement and provisionalization. In order to reduce trauma to both soft and hard tissues, the upper right and left central and lateral incisors were extracted without elevating the gum flap. Subsequently, a dental implant was promptly inserted using a surgical guide with bone graft and furnished with a provisional crown that did not contact the opposing teeth. Throughout the healing period, no notable negative effects were observed in both clinical assessments and X-rays. This proposed treatment approach offered the patient immediate improvements in esthetics, functionality, and comfort without encountering any complications., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Takvani et al.)

Purpose: To report the clinical and radiographic outcomes of a 3-year follow-up of immediately and early loaded two-implant-supported mandibular overdentures. Materials and Methods: Forty edentulous patients were randomly subdivided into two groups. In the immediate loading group, two Straumann implants were splinted with a Dolder bar and loaded with a mandibular overdenture within the first 48 hours postoperative. In the early loading group, the two implants were loaded with an overdenture 6 weeks postoperative. Standardized intraoral radiographs using a film holder were obtained at 1 month and 3 years. Two independent observers assessed marginal bone loss twice, independently, and analysis of variance (ANOVA) was used to follow up marginal bone level changes. Results: In total, there were 26 remaining patients available at the 3-year followup (15 immediate and 11 early). One implant was lost in the early loading group, and no implants were lost in the immediate loading group. All superstructures and dentures were adequately functional at the 3-year control. Mean radiographic marginal bone loss between baseline and the 3-year follow-up was 0.35 ± 0.63 mm for immediately loaded implants and 0.31 ± 0.96 mm for early loaded implants. The difference between the two groups was not statistically significant (P = .26). Conclusion: Within the limitations of this trial and the short follow-up period and high dropout rate, the immediate loading protocol was found to be comparable in its clinical and radiographic outcomes to the early loading protocol for the two-implant Dolder bar-supported mandibular overdentures. [ABSTRACT FROM AUTHOR]

Purpose: To compare peri-implant bone and soft-tissue levels of immediate non-occlusally loaded versus non-submerged early loaded implants in partially edentulous patients 10 years after loading. Materials and methods: Fifty-two patients were randomised in five Italian private practices: 25 in the immediately loaded group and 27 in the early loaded group. To be immediately loaded, single implants had to be inserted with a torque of at least 30 Ncm, and splinted implants with a torque of at least 20 Ncm. Immediately loaded implants were provided with non-occluding temporary restorations within 48 h. After 2 months, the provisional restorations were put in full occlusion. Implants were early loaded after 2 months. Definitive restorations were provided 8 months after implant placement. Outcome measures were prosthesis failures, implant failures and complications, recorded by non-blinded assessors, and peri-implant bone and soft-tissue levels evaluated by blinded assessors. Results: Fifty-two implants were loaded immediately and 52 early. Three patients with 8 implants dropped out from the immediate group versus two patients with 3 implants from the early loaded group; all remaining patients were followed for at least 10 years after loading. One single immediately loaded implant failed 2 months after placement. Three patients with immediately loaded implants and two with early loaded implants were affected by complications. There were no statistically significant differences for implant/prosthesis failures (Fisher's exact test: P = 0.294; difference = 4%, 95% CI: -16% to 24%) and complications between groups (Fisher's exact test: P = 0.574; difference = 4.5%, 95% CI: -12% to 21%). Both groups gradually lost peri-implant bone in a highly statistically significant way at 2, 8 and 14 months, and at 4, 5 and 10 years. After 10 years, immediately loaded patients lost an average of 1.34 mm and early loaded patients lost 1.42 mm of peri-implant marginal bone. At 10 years, there was a statistically significant recession (P < 0.001) of the vestibular soft tissues from baseline (delivery of the final restorations 8 months after implant placement) at both immediate (0.38 mm) and early (0.25 mm) loaded implants. There were no statistically significant differences in terms of peri-implant bone (difference = 0.08 mm, 95% CI: -0.49 to 0.65; P = 0.49) and soft-tissue level changes (difference = 0.07 mm, 95% CI: -0.48 to 0.62; P = 0.469) between the two groups at 10 years after loading. Conclusions: In well-maintained patients, complications are uncommon and healthy and stable periimplant tissues can be maintained for 10 years around both immediate and early loaded implants. [ABSTRACT FROM AUTHOR]

Purpose: To compare the clinical outcome of single, partial and full fixed implant-supported prostheses immediately loaded (within 48 h), early loaded at 6 weeks and conventionally loaded at 3 months (delayed loading). Materials and methods: Eighty-one patients (27 requiring single implants, 27 requiring partial fixed prostheses and 27 requiring total fixed cross-arch prostheses) were randomised in equal numbers in three private practices to immediate loading (27 patients), early loading (27 patients) and conventional loading (27 patients) according to a parallel group design with three arms. To be immediately or early loaded, implants had to be inserted with a torque superior to 40 Ncm. Implants were initially loaded with provisional prostheses and replaced after 4 months by definitive ones. Outcome measures were prosthesis and implant failures and complications. Results: No patient dropped out up to 4-months post-loading. No implant or prosthesis failed or any complications occurred. Conclusions: All loading strategies were highly successful and no differences could be observed for implant survival and complications when loading implants immediately, early or conventionally. [ABSTRACT FROM AUTHOR]

Introduction: Osseointegration is considered one of the most important deciding factors to check for implant stability, which decides successful outcome of the implant. Photobiomodulation has been used to improve the implant stability by enhancing osseointegration. Photobiomodulation (PBM) or Low-level Laser Therapy (LLLT) causes an enhanced effect in the bone implant contact. Need for the Study: There are no definitive therapies/protocol of LLLT in cases of bone density of D3 and D4. Also There are no studies in literature which compares the different laser settings so that a standardised setting can be established. Therefore, there is need to generate evidence whether reducing the number of appointments and reducing the amount of energy given in D3 and D4(compromised) bone can help achieve early loading in patients. Aim: To evaluate and compare the effect of three different photobiomodulation therapies on primary and secondary implant stability in D3 and D4 bone type in comparison to control group to achieve early loading. Materials and Methods: This randomized controlled, double blinded study allocated 108 patients having D3 or D4 bone according to Misch classification into six groups. Three different PBM therapy which is either Therapy A, B or C(placebo) will be used. The implant stability will be measured by Ostell meter in Implant Stability Quotients (ISQ) scale, immediately after surgery, after 3 weeks, after 12 weeks and after 6 months of surgery. The bone density will be measured before surgery and 3 months after surgery. Expected Outcome: At the end of the study, an evidence will be generated whether reducing the number of appointments and reducing the amount of energy given in D3 and D4(compromised) bone can help achieve early loading in patients. Patients treated using PBM therapy either protocol A or protocol B may show enhanced implant stability. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate marginal bone loss 6 and 12 months after prosthetic loading of implants with Dynamic Bone Management (Straumann, Basel, Switzerland) through the implementation of different drilling protocols. Materials and methods: A balanced, randomised, single-blind clinical trial was conducted with four parallel experimental arms: immediate loading and under-drilling, immediate loading and complete drilling, early loading and under-drilling, and early loading and complete drilling. Fortyfour implants with a Dynamic Bone Management design and with a diameter of 3.75 mm and a length of 10.00 mm were placed in healed mature bone (more than 6 months post-extraction). Results: The mean primary stability achieved was 60.6 ± 12.2 implant stability quotient, with a range from 21 to 75, and no differences were observed when considering the drilling protocol used, bone type or location. Early loading resulted in a loss of 0.728 mm (standard error 0.212; 95% confidence interval 1.134 to -0.325; t value -3.440), whereas immediate loading did not result in any bone loss. When the interaction between the loading and drilling protocols was studied, performing the complete drilling protocol in conjunction with early implant loading was found to result in lower marginal bone loss, with a marginal bone gain effect of 0.814 mm (standard error 0.283; 95% confidence interval -0.274 to 1.353; t value 2.880). Conclusions: Use of the complete drilling protocol in conjunction with early implant loading resulted in the lowest marginal bone loss at 12 months. [ABSTRACT FROM AUTHOR]

Background: Understanding the changes in bone density after insertion of dental implants and their relation to immediate/early loading is essential to achieving improvements in their survival rate. Histological investigations of the bone bed in humans are limited, which in turn hampers opportunities to deepen knowledge about the remodeling process around dental implants. Purpose: The aim of this pilot study was to comparatively evaluate the bone density changes around root-form, threaded collar, two-piece endosseous implants at three different levels as influenced by early and conventional protocols using cone-beam computed tomography (CBCT). Methodology: Twenty implants were placed in 20 patients who were randomly assigned to two groups. Group A (n = 10 implants, 10 patients) received conventional loading protocol and Group B (n = 10 implants, 10 patients) followed early loading protocol following implant placement. Bone density changes were evaluated and compared as influenced by early and conventional protocols using CBCT (gray values).The gray values were measured at the apical level, middle region of radiological implant length, and at the crestal level. The measurements were made immediately (T0) and 36 weeks (T1) post implant placement. Results: Intergroup comparison of bone density changes was done between Group A (conventional loading) and Group B (early loading) from immediate post implant placement to 36 weeks post implant placement follow-up. From immediate post implant placement to follow-up, significant difference was seen in bone density of Group A and Group B at apical and middle levels as P < 0.05, but at crestal level, no significant difference was seen. Conclusion: Under the conditions of this study, early loading significantly densified more bone as compared to conventional loading. Further studies are required to determine CBCT gray values and its correlation with computed tomography Hounsfield units for quantification of the bone. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate clinical safety and effectiveness of a novel calcium-incorporated titanium implant surface (Xpeed, MegaGen Implant Co., Gyeongbuk, South Korea). Materials and methods: Sixty patients were randomised to receive one to six implants in the maxilla with either calcium-incorporated (Xpeed) or control resorbable blasted media (RBM) surfaces, according to a parallel group design at two centres. Implants were submerged and exposed at three different endpoints in equal groups of 20 patients, each at 12, 10 and 8 weeks, respectively. Within 2 weeks, implants were functionally loaded with provisional or definitive prostheses. Outcome measures were prosthesis failures, implant failures, any complications and peri-implant marginal bone level changes. Results: Thirty patients received 45 calcium-incorporated implants and 30 patients received 42 control titanium implants. Three years after loading four patients dropped-out from the Xpeed group and one from the RBM group. No prosthesis or implant failures occurred. There were no statistically significant differences between the groups for complications (P = 0.91; difference in proportions = 0.79 %; 95% CI -0.71 to 2.29) and mean marginal bone level changes (P = 0.88; mean difference = -0.02 mm; 95% CI -0.26 to 0.22). Conclusions: Both implant surfaces provided good clinical results and no significant difference was found when comparing titanium implants with a nanostructured calcium-incorporated surface versus implants with RBM surfaces. [ABSTRACT FROM AUTHOR]

Purpose: To compare the clinical outcome of single implants which underwent immediate non-occlusal loading with implants subjected to early non-occlusal loading at 3 weeks, and implants conventionally loaded at 4 months. Materials and methods: One hundred and five patients in five private practices requiring a single implant-supported crown were randomised to immediate loading (35 patients), early loading (35 patients) and conventional loading (35 patients) groups. To be immediately or early loaded, implants had to be inserted with a torque superior to 45 Ncm. Immediately and early loaded implants received non-occluding temporary crows, whereas conventionally loaded implants were directly restored with definitive crowns. Temporary crowns were replaced by definitive ones after 4 months. Outcome measures were crown and implant failures, complications and peri-implant marginal bone level changes recorded by a blinded assessor. Results: Two patients dropped out from the immediate loading group up to 1-year post-loading. Two implants failed, one in the immediately loaded and one in the early loaded group (P = 0.601). One immediately loaded implant and two early loaded implants were affected by one complication each (P = 0.162). Mean peri-implant marginal bone loss after 1 year was -0.120 ± 0.230 mm (95% CI -0.35, 0.10) for immediate, -0.390 ± 0.840 mm (95% CI -1.23, 0.45) for early and -0.201 ± 0.306 mm (95% CI -0.51; 0.11) for conventionally loaded implants. There were no statistically significant differences for any of the outcome measures between the three loading strategies up to 1-year post-loading. Conclusions: No major clinical differences were observed with regard to implant survival, complications and marginal bone level changes when loading single implants immediately, early or conventionally. [ABSTRACT FROM AUTHOR]

Objectives: This publication reports on the EAO workshop group 1 summaries, discussions and consensus statements based on four systematic reviews evaluating the impact of timing of dental implant placement and loading. Materials and methods: The first of the systematic reviews was on the influence of the timing of implant placement and loading in the biological outcomes of implant‐supported fixed partial dentures. The second systematic review evaluated the influence of the timing of implant placement and loading on the aesthetic outcomes in single‐tooth implants. The third systematic review was on the long‐term outcomes of maxillary single‐tooth implants in relation to timing protocols of implant placement and loading and the fourth on patient's perception of timing concepts in implant dentistry. The group evaluated these systematic reviews, provided comments and additions as required and agreed on the relevant consensus statements as well as on clinical and research recommendations. Results: Different timings of implant placement/loading presented with high implant survival rates. The systematic reviews evaluated from this working group provided a number of conclusions based on the available/current literature. However, the specific topic of timing is an area that further research is required in order to provide detailed guidelines for the different protocols to be employed. [ABSTRACT FROM AUTHOR]

Purpose: The purpose was to evaluate the difference in crestal bone loss (CBL) around implants with flap and flapless methods followed by early loading. Materials and Methods: Twenty implants were placed in twenty patients - ten using flap and ten using flapless techniques. The difference in CBL was measured on standardized digital periapical radiograph taken at 0 week, 6 weeks, 12 weeks, and 6 months. Results: The present study showed the mean CBL on proximal surfaces when evaluated at intervals of 0 week, 6 weeks, 12 weeks, and 6 months for flapless method was significantly lower than with flap method the values of which were +0.07 mm against +0.26 mm on mesial side and +0.15 mm against +0.33 mm on distal side at 6 months. Conclusion: The flapless approach is a predictable procedure when patient selection and surgical technique are appropriate, and results in lesser CBL. [ABSTRACT FROM AUTHOR]

Purpose: The purpose was to evaluate the difference in crestal bone loss (CBL) around implants with flap and flapless methods followed by early loading. Materials and Methods: Twenty implants were placed in twenty patients – ten using flap and ten using flapless techniques. The difference in CBL was measured on standardized digital periapical radiograph taken at 0 week, 6 weeks, 12 weeks, and 6 months. Results: The present study showed the mean CBL on proximal surfaces when evaluated at intervals of 0 week, 6 weeks, 12 weeks, and 6 months for flapless method was significantly lower than with flap method the values of which were +0.07 mm against +0.26 mm on mesial side and +0.15 mm against +0.33 mm on distal side at 6 months. Conclusion: The flapless approach is a predictable procedure when patient selection and surgical technique are appropriate, and results in lesser CBL. [ABSTRACT FROM AUTHOR]

Purpose: To systematically evaluate implant success rates with different loading protocols. Materials and Methods: A search was conducted of electronic databases, including The Cochrane Oral Health Group's Trials Register, PubMed, SciSearch, Medline, and EMBASE, for all randomized controlled trials published between 1997 and 2011 to compare implant success rates among different loading methods. The quality of randomized controlled trials was critically appraised, and the data were extracted by two independent reviewers. Meta-analyses were conducted of the eligible randomized controlled trials. Results: A total of 26 randomized controlled trials met the criteria for meta-analysis. The quality of these articles was moderate. Eight trials compared immediate and early loading (relative risk [RR] = 0.90, 95% confidence interval [CI] 0.42-1.93, P = .79), 7 compared early with delayed loading (RR = 1.19, 95% CI 0.52-2.72, P = .69), and 11 compared immediate and delayed loading (RR = 1.19, 95% CI 0.52-2.72, P = .69). Conclusions: The limited evidence shows that there is no significant difference in implant success rates with different loading protocols. [ABSTRACT FROM AUTHOR]

Background: Various surface treatment options have been adopted with the aim to improve osseointegration, reducing the overall treatment time. Implant stability of early loaded implants with different modified surfaces was compared in the present study. Methods: Patients were selected from the Department of Oro-Maxillofacial Surgery and Stomatology at Semmelweis University. Patients randomly received SA (alumina sandblasted and acid-etched), NH (bioabsorbable apatite nanocoating) or SLA (large-grit sandblasted and acid-etched) surface implants. Outcome measures were: implant success, implant stability, and periodontal parameters. The implant stability was measured at the time of implant placement (primary stability) and six weeks after (prothesis delivery, secondary stability). Osstell and Periotest were applied to take all the measurements. The primary and secondary stability were compared in the three study groups Finally the periimplant probing depth appearing after three months of loading was checked on 6 points around to the implant-supported prostheses. Shapiro–Wilk and Mann–Whitney tests were used for the comparison between the study groups. Results: A total of 75 implants with different length and diameter were inserted into various positions. One implant failed spontaneously at the fourth week after implant placement. The survival rate was 98,7%. Comparing the primary and secondary stability values, the data were significantly improved in every groups. The difference was the highest in the NH group, however, this difference was not significant compared to the two other groups. Good periodontal parameters were experienced in all the tested implants, independently by the groups. Conclusions: With the limitation of the present study, all the implants showed improved stability six weeks after implant placement. A trend of higher result was found for the NH group. Further studies with longer follow-up are needed to confirm this preliminary results. Trial registration: Current Controlled Trials ISRCTN13181677; the date of registration: 04/03/2021. Retrospectively registered. [ABSTRACT FROM AUTHOR]

Featured Application: The following paper presents the issue of early loading of dental implants. Nowadays, the most frequently used prosthetic protocol is loading the implant within 12 weeks. It is believed that the recently introduced nano-scale modification of the implant's surface will allow for faster final loading. Faster final loading reduces the overall treatment time which is even more crucial in the case of aesthetic zone rehabilitation. (1) Background: implant surface topology and active hydrophilic ions could have some benefit on implant osteointegration and stability; (2) methods: 40 adult patients, suffering from a single missing tooth in the aesthetic zone, were enrolled in the study. Each patient had a single titanium implant (Thommen SPI®lement) inserted. The implant surface was obtained through conditioning using the Apliquiq system. Patients were divided into two equal groups depending on the implant's diameter (3.5 and 4.0 mm). Each implant was loaded within four weeks. Stability levels, using the Ostell device, were checked immediately after implant placement and in four weeks; additionally, marginal bone loss (MBL) was calculated based on 12 months; (3) results: all implants survived the study. The average primary stability achieved for both groups was initially 71.59 ISQ (±4.04) and declined to 69.94 ISQ (±3.29) in four weeks. The average MBL was 0.2 mm (±0.88). There were no statistically important differences between groups. There was a positive correlation between the patient's age and implant stability quotient (ISQ) values; (4) conclusions: hydrophilic surface implants can be used in a protocol for early functional occlusal loading. Higher values of primary stability positively influence the values of secondary stability, and the age of the patient affects the values of implant stability. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to compare delayed and early loaded single-tooth implant technique. Materials and Methods: A randomized, prospective clinical trial was conducted to evaluate the clinical and radiological parameters of delayed and early loading of single-tooth implant placement. Fourteen male or female patients were selected randomly, who had single tooth missing in mandibular posterior region. A delayed implant placement technique was followed in these regions. A Hi-Tech implant (Life Care Implants) was performed. The patients were divided into two groups: delayed loading group and early loading group. In delayed loading groups, implants were loaded after 3 months, and in early loading groups, implants were loaded within 7 days to 2 months. Soft tissue and radiological bone loss were assessed at baseline, 3 months, and 6 months. The parameters assessed were plaque index, gingival index, probing pocket depth, thickness of peri-implant mucosa, and bone loss (radiographically). Results: The results show that there was no statistical difference in indexes taken between delayed loading and early loading groups. Conclusion: In this study, after first 6 months there was no difference in success rate between delayed loading or early loading of implants. This study also showed that more bone loss occurred around delayed loading implants. So it can be concluded that early loading technique can be successfully practiced instead of delayed loading of implants.

Purpose: The aim of this study was to systematically review the evidence for immediate implant loading in partially edentulous patients with extended edentulous sites and evaluate potential treatment modifiers. Materials and Methods: An electronic search was performed in Medline, Embase, and Central to identify studies investigating the outcome of implants subjected to immediate loading (IL) (less than 1 week), early loading (EL) (1 week to 2 months), or conventional loading (CL) (more than 2 months) with implant-supported fixed dental prostheses (IFDPs) in partially edentulous patients with extended edentulous sites, ie, at least two adjacent teeth are missing. Only human studies with at least 10 cases and a minimum follow-up time of 12 months, reporting on solid-screw–type implants with rough surfaces and a diameter of at least 3 mm, were included. Weighted means of implant survival rates and risk ratios for implant survival at 1 year using meta-analytic tools were calculated to perform the following comparisons: IL vs EL, IL vs CL, and IL in the maxilla vs mandible. Noncomparative studies reporting on IL and EL protocols were summarized through descriptive methods. Results: The search provided 3,872 titles, 837 abstracts, and 444 full-text articles. A total of 24 publications that comprised six comparative studies (five randomized controlled trials, one nonrandomized controlled trial) and 18 noncomparative studies were included for analysis. The comparison of weighted mean survival rates revealed no statistically significant difference between IL (97.9%) and EL (97.8%, P = .9405), and between IL (100%) and CL (99.3%, P = .3280). Meta-analysis showed no statistically significant difference in implant survival at 1 year between IL and EL (RR 0.90; 95% CI 0.30, 2.70; P = .502). A meta-analysis comparing IL and CL could not be performed due to the low number of failures. No statistically significant difference was found for IL implants placed in the maxilla vs the mandible (RR 1.55; 95% CI 0.49, 4.84; P > .05). Due to the small number of IL implants placed in the anterior, a comparison between implant survival in anterior vs posterior zones was not performed. Treatment modifiers were bone quality, primary stability, insertion torque, ISQ values, implant length, the need for substantial bone augmentation, the timing of implant placement, and the presence of parafunctional and smoking habits. Conclusions: IL presents similar implant survival rates as EL or CL for partially edentulous patients with extended edentulous sites in the posterior zone, as long as strict inclusion/exclusion criteria are followed. There is a lack of evidence for IL of multiple implants in the anterior zone of partially edentulous patients. Preliminary evidence suggests that IL may be equally successful in either the maxilla or mandible. Further research is needed before IL in partially edentulous patients with extended edentulous sites can be recommended in everyday practice. [ABSTRACT FROM AUTHOR]

Purpose: To compare implant failure, prosthesis failure and radiographic bone level changes of immediate non-occlusal loading versus early loading in partially edentulous patients 3 years after implant placement. Materials and methods: A total of 80 patients with partial edentulism were selected for a two implant-supported immediate restoration and randomised to immediate loading (test group) or early loading (control group) after 2 months, 40 patients for each group. To be included in the study, implants had to be inserted with a torque AO Ncm. In the test group, implants were provided with non-occluding temporary restorations. In the control group, healing abutments were attached and implants were left to heal nonsubmerged. Definitive prostheses were delivered 2 months after surgery with full occlusal contacts. The outcome variables were implant failure, prosthesis failure, complications and radiographic bone level changes at implants 3 years after loading. The assessor was blinded to group assignment. Results: Eighty-one implants were immediately loaded and 80 were early loaded. Two immediately loaded patients and 1 early loaded patient dropped out at 3 years. No implant failed. Two complications occurred in the immediate loading group and 1 in the early loading group. There were no significant differences in bone levels changes at 36 months between the two groups (P = 0.67; difference 0.2 mm; 95% CI -0.23, 0.63). Immediately loaded implants lost 0.90 mm (95% CI 0.63, 1.17) and early loaded implants 1.10 mm (95% CI 0.81, 1.39). Conclusion: If adequate primary stability was achieved, no statistically significant difference in failure rates, complications or bone level changes between implants loaded immediately or early were observed 3 years after placement in partially edentulous patients. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated the survival and success rates and marginal bone loss conditions of early-loaded implants in the posterior maxilla and mandible of partially edentulous patients. Materials and Methods: Implants (n = 299) were placed in 105 patients at two research centers. Provisional fixed dental prostheses were provided to the patients between 1 week and 2 months after implant placement. The implants were classified into four groups according to the loading time (1 to 2, 2 to 4, 4 to 6, and 6 to 8 weeks). Periapical radiographs were taken via a parallel imaging technique, and the peri-implant marginal bone level was measured on the radiographic images. Results: Most implants were lost within 1 month, and one implant was removed at 36 days after loading. The cumulative survival rate of the implants was 97.0%. Implants loaded in the maxilla at 1 to 2 weeks after prosthesis insertion had significantly lower survival rates than any other group (P = .013). There were no significant differences in marginal bone levels among the implant groups classified according to loading time. Conclusions: Early loading is a safe and predictable procedure for implant-supported restoration of posterior partial edentulism. However, care must be taken in early loading within 2 weeks after maxillary implant insertion. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy of long implants (10–16 mm) inserted in maxillary sinuses augmented according to a lateral approach versus short (8 mm) implants placed in crestally augmented sinuses, early loaded after 45 days. Materials and methods: Forty partially or fully edentulous patients having 3 to 6 mm of residual crestal height and at least 4 mm in thickness below the maxillary sinuses were randomised according to a parallel group design to receive either one to three 10 to 16 mm-long hydroxyapatite-coated implants (20 patients) after lateral sinus lifting with 50% an organic bovine (Bio-Oss) and 50% autogenous bone, or 8 mm implants (20 patients) after crestal sinus lifting with autogenous bone. Implants were submerged and left healing for 45 days before loading the implants. Within 1 week after abutment connection, implants were loaded with screw-retained full acrylic provisional prostheses. Definitive metal-ceramic prostheses were provisionally cemented 45 days after abutment connection. Outcome measures were prosthesis and implant failures, any complications, and radiographic periimplant marginal bone level changes. In addition, the stability of individual implants was assessed with Osstell and Periotest at abutment connection (baseline), and at 1 and 5 years after loading by blinded outcome assessors. All patients were followed up to 5 years after loading.Results: One patient dropped out (death) from the longer implant group. One implant failed in the short implant group versus 5 implants in 3 patients of the longer implant group. The difference was not statistically significant. Four complications occurred in 4 patients of the short implant group versus 8 complications in 7 patients of the long implant group, the difference being not statistically significantly different. However, the 2 major postoperative complications occurred in the longer implant group: 1 abscess, and 1 sinusitis that led to the complete failure of the treatment in 2 patients (4 implants lost). A total of 0.72 mm of peri-implant marginal bone was lost after 5 years at long implants and 0.41 mm at short implants, the difference between the two groups was statistically significant (P = 0.028). Osstell values increased and Periotest decreased over time and there were no differences between groups at any time points. Conclusions: In atrophic maxillary sinuses with a residual bone height of 3 to 6 mm, 8 mm short implants placed in a simultaneously crestally lifted sinus might be a preferable choice than a 1-stage lateral sinus lift for placing longer implants since they appear to be associated with less morbidity. If these implants are placed with an insertion torque >35 Ncm and are joined together under the same prosthesis, they can be early loaded at 6 weeks. Conflict-of-interest statement: This study was completely self-supported and no contribution from any commercial party was received, including support in the form of free materials. [ABSTRACT FROM AUTHOR]

Objectives: To compare the marginal bone level around implants with a thin multi‐phosphonate coated surface after either an early or conventional loading protocol. Material and methods: A randomized pilot clinical trial was conducted. Dental impressions were obtained after either 4 (test) or 8 weeks (control) and single crowns screwed‐in 2 weeks later. Several variables were evaluated including radiographical marginal bone level (MBL), patient's level variables, and those related to the restoration and surrounding tissues. These data were obtained at several time points up to a 1‐year follow‐up. Results: Thirty‐four patients were included in the study, 18 assigned to the test group. No differences at implant placement were detected for tissue thickness, keratinized mucosa, nor any other clinical or radiological variable. At the time of impressions, tissue was thinner in the test group (2.30 (0.46) versus 2.78 (0.66) mm, test versus control, respectively; p =.012) so shorter abutments were used in this group. Regardless, no significant changes in marginal bone level were detected neither within group along time nor between groups. The average MBL at the 1‐year follow‐up was −0.15 (0.32) versus −0.22 (0.37) (p =.443) (test versus control, respectively). None of the clinical or radiological variables evaluated had a determinant influence on the MBL at any visit nor group. Conclusion: The use of implants with a multi‐phosphonate coated surface for early loading offers successful radiographical outcomes 1 year after loading. MBL over time was not affected by taking the impressions 4 or 8 weeks after implant placement and loading them 2 weeks later. [ABSTRACT FROM AUTHOR]

Aims: The study compared changes in implant stability and bone loss of implants with different designs using early loading at 6 weeks. Setting and Design: In vivo-comparative study. Materials and Methods: Forty subjects were selected and divided randomly by sealed envelope method in Group X and Group A for early loading for missing single posterior tooth in mandible. Implants in Group X had flared crest module and buttress thread design, whereas implants in Group A had parallel crest module and V-shaped thread design. All subjects were evaluated by Ostell for implant stability at the interval of baseline, 6 weeks, 3 months, and 6 months. ImageJ software was used for measurement of crestal bone loss in intraoral periapical radiographs at the interval of 6 weeks, 3 months, and 6 months. Statistical Analysis Used: Unpaired t test, repeated ANOVA, Tukey post hoc test. Results: The mean bone loss values of Group X at predetermined interval were 1.51 ± 0.20 mm, 2.11 ± 0.21 mm and 2.13 ± 0.21 mm. The mean bone loss values of Group A were 1.79 ± 0.16 mm, 2.92 ± 0.23 mm and 2.95 ± 0.23 mm. The mean bone loss was statistical significant (P < 0.05) at 6 weeks, 3 months and 6 months. It was highly significant in Group A at 6 months (P < 0.001). Conclusions: It was concluded that Group X implants design showed better implant stability and less bone loss when compared to Group A implants design. [ABSTRACT FROM AUTHOR]

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Purpose: To evaluate clinical safety and effectiveness of a novel calcium-incorporated titanium implant (Xpeed, MegaGen Implant Co. Limited, Gyeongbuk, South Korea). Materials and methods: Sixty patients were randomised to receive either 1 to 6 calcium-incorporated or control titanium implants in the maxilla according to a parallel group design at 2 different centres. Implants were submerged and exposed at 3 different endpoints in equal groups of 20 patients each at 12, 10 and 8 weeks, respectively. Within 2 weeks, implants were functionally loaded with provisional or definitive prostheses. Outcome measures were prosthesis failures, implant failures, any complications and peri-implant marginal bone level changes. Results: Thirty patients received 45 calcium-incorporated implants and 30 patients received 42 control titanium implants. One year after loading, no drop-outs and no prosthesis or implant failures occurred. There were no statistically significant differences between groups for complications (P = 0.61; difference in proportions = -0.27; 95% CI -0.71 to 0.18) and mean marginal bone level changes (P = 0.64; mean difference -0.04 mm; 95% CI -0.22 to 0.13). Conclusions: Nanostructured calcium-incorporated titanium implants seem to be at least as effective and safe as conventional titanium implants. Conflict-of-interest statement: MegaGen partially supported this trial and donated the implants and prosthetic components. The study design was negotiated with MegaGen Implant Co. Limited, Gyeongbuk, South Korea, however, the data was the sole property of the authors and by no means did MegaGen interfere with the conduct of the trial or the publication of its results. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the medium-term effectiveness of 6.5 mm-long flapless-placed single implants immediately or early loaded at 6 weeks. Materials and methods: Thirty patients received two single NanoTite external hex Biomet 3i implants each, which were then randomly allocated to be immediately or early loaded according to a split-mouth design. Implants had to be inserted with a minimum torque of >40 Ncm. Provisional crowns were put in slight occlusal contact and replaced by definitive crowns 3 months after loading. Patients were followed for 4 years after loading. Outcome measures were implant failures, biological and biomechanical complications, peri-implant marginal bone level changes, and patient preference. Results: Twenty-nine implants were immediately loaded and 31 early loaded. Four years after loading, no drop-outs occurred. One implant failed in each group within 2 months after loading. Seven patients experienced complications at immediately loaded implants and 6 at early loaded implants. There were no statistically significant differences between groups for implant losses, complications, mean marginal bone level changes and patient preference. Conclusions: Flapless-placed 6.5 mm-long single implants can be immediately loaded and remain successful up to 4 years after loading. Even longer follow-ups are still needed to evaluate the long-term prognosis of short implants. [ABSTRACT FROM AUTHOR]

Purpose: To determine the change in stability of three different implant systems using resonance frequency analysis (RFA) and to correlate RFA measurements with factors related to implant design, length, and diameter, patient gender, and dental arch. Clinical and radiologic evaluations were performed up to 1 year after loading. Materials and Methods: Three different types of implants from three different manufacturers were inserted in the posterior maxilla and mandible. RFA measurements were performed at implant placement and weekly up to 8 weeks postoperatively and were compared with respect to implant type, length, and diameter and dental arch. The implants were loaded after 8 weeks. All implants were examined radiographically at baseline and at 6 and 12 months. Plaque Index, Sulcus Bleeding Index, peri-implant probing depths, and marginal bone loss were recorded. Repeated-measurements analysis of variance, two-tailed mixed-model analysis of variance, the Least Significant Differences and Mann-Whitney U tests were used for statistical analyses. Results: All the groups showed high stability values at all time points (above 71). There were statistically significant differences between groups at all time points except 1 and 2 weeks. Mandibular implants showed statistically higher stability values than maxillary implants. Wide implants showed statistically higher stability values than narrow implants. Mean marginal bone loss was 0.22 ± 0.47 mm after 1 year. Conclusions: All three implant systems showed clinically acceptable stability values prior to early loading. The success rates and bone loss were similar to the values reported in the literature. [ABSTRACT FROM AUTHOR]

Purpose: For dental implants to be successful, osseointegration must occur, but it is unknown how much time must pass for osseointegration to be established. Preclinical studies suggested that titanium implants with a sandblasted and acid-etched (SLA) surface were more osteoconductive and allowed more rapid osseointegration than machined or turned implant surfaces. The hypothesis of this study was that implants with an SLA surface could be loaded in half the conventional healing time of machined-surface implants and that, after loading, the implants would be successful for 5 years. Materials and Methods: A prospective multi-center clinical study was conducted with 439 implants placed in native bone in 135 edentulous and partially edentulous patients. Abutments were attached to the implant with 35 Ncm of torque without counter-torque after 6 weeks in type I to III bone and after 12 weeks in type IV bone. The patients were carefully evaluated for 5 years. Results: Most implants were placed in nonsmoking, nondiabetic patients with a mean age of 55 years (range, 21 to 82 years). Eighty percent of the implants were 10 or 12 mm long, 96% had a diameter of 4.1 mm, and 78% were placed in type II or III bone. Patients maintained good oral hygiene and were satisfied with the restorations. Four implants failed, and one implant was deemed unsuccessful between surgery and the 1-year post-loading visit. No implants failed or were unsuccessful in subsequent years. The cumulative survival and success rates for 385 implants in 120 patients after 5 years were 99.1% and 98.8%, respectively. Conclusion: Implants with an SLA surface can be restored in 6 weeks for type I to III bone and 12 weeks for type IV bone. Furthermore, they can be maintained after loading for 5 years with very high success and survival rates. Int J Oral Maxillofac Implants 2011;26:1324-1332 [ABSTRACT FROM AUTHOR]