Presurgical Planning With CT-Derived Fabrication of Surgical Guides

As implant dentistry is evolving toward accelerated treatment protocols, with immediate or delayed functional and nonfunctional loading, the importance of presurgical planning becomes paramount. The paradigm for restorative-driven implant placement works best when templates are used to transfer information from the desired plan to the surgical reality. The advent of computed tomography (CT) imaging, and CT-derived surgical templates allow for clinically significant improvements in accuracy, time efficiency, and reduction in surgical error, benefiting the patient, surgeon, restorative dentist, and the laboratory. Continued advances in the state-of-the-art software applications that enable enhanced planning give clinicians the vision necessary to deliver the desired results, while serving as an excellent communication tool between all members of the implant team. This article illustrates the advantages of using CT scan-based templates through various clinical presentations. Procedures were illustrated for single and multiple tooth applications in both mandibular and maxillary arches.

Performance of Short Implants in Partial Restorations: 3-Year Follow-up of Osseotite® Implants

Short-length implants should be at a performance disadvantage because of the more limited surface area with which to resist occlusal forces. Nevertheless, anecdotal observations find many short implants performing well in different restorative conditions. This retrospective, multicenter study seeks to compare formally implant performance based on length. The success of 7 and 8.5-mm Osseotite implants (Implant Innovations, Inc., Palm Beach Gardens, FL) was determined as: absence of mobility; no persistent and/or irreversible signs or symptoms of pain, infection, paresthesia, or violation of the mandibular canal; no evidence of peri-implant radiolucency; and no progressive crestal bone loss. Implant location, restoration type, bone density, and smoking status of the patients were recorded. A total of 188 patients received 311 short Osseotite implants that were placed mostly in soft bone and supported 216 partially edentulous cases in the maxilla or mandible. Most restorations (95.2%) are short-span fixed partial dentures placed in the posterior sextants. During 3 years of follow-up, 13 implants failed, yielding a cumulative success rate of 95.8%. In 9 of these cases, failure occurred before prosthetic loading, and in 4, the patient was a smoker. The overall success rate compares favorably with the available literature for the performance of implants in general, and short implants in particular.

Fractal dimension and lacunarity analysis of dental radiographs

OBJECTIVE

As the occlusal forces transmitted to the jaw bones during mastication might be different in dentate and edentulous regions, there might be different radiographical trabecular bone texture in these regions. Image analysis procedures are promising techniques which are used to detect structural changes of bone texture on radiographs. In this study, the differences of fractal dimension (FD) and lacunarity measurements of radiographical trabecular bone between dentate and edentulous regions were investigated.

METHODS

Direct digital radiographs of premolar-molar region were taken from 51 patients who were included in our study. Two rectangular regions of interest (ROIs) with the same dimensions (37x119 pixels) were created on these radiographs; one in the edentulous region and the other one in the dentate region. The ROIs were segmented as black and white areas. Box-counting fractal dimension and lacunarity of these regions were calculated.

RESULTS

Paired samples t-test and Pearson correlation coefficients were calculated. It was found that there were differences between dentate and edentulous regions for FD and lacunarity (P=0.000). There is a negative correlation between FD and lacunarity (-0.643, P<0.01), positive correlation between dentate and edentulous regions and FD (0.819, P<0.01), and a negative correlation between lacunarity and dentate and edentulous regions (-0.541, P<0.01).

CONCLUSIONS

The differences of occlusal forces generated in dentate and edentulous regions during mastication cause some alterations in trabecular bone structure, and fractal dimension and lacunarity can reveal these alterations quantitatively.

Clinical and radiographic behaviour of 290 dental implants with a surface treated with hydrofluoric acid and passivated with hydrofluoric and nitric acid: early loading results after 2 years

OBJECTIVE

This work presents the results of clinical and radiological behaviour, for 2 years, of 290 implants treated with a first etching with HF and a second etching with HF and HNO3 acids and that were loaded 8 weeks after insertion.

EXPERIMENTAL DESIGN

It is a prospective study on 290 implants placed in 56 patients with an age range from 28 to 81. The selection was previously made through radiological study with panoramic and tomographic radiographs, followed by the implantological treatment with prosthetic loading and clinical (15 days, 1, 3 , 6, 12, 18 and 24 months) and radiological control (12 and 24 months).

RESULTS

During the healing period, 11 implants failed, resulting in a CSR of 96.21%. After prostheses placement at 2 months, 4 implants were retired, successfully remaining 275 implants.

CONCLUSIONS

The following and favourable results after the prosthetic loading of 179 implants (CSR of 98.56%), attest that early loading may and must be applied, after rigorous planning and case selection.

Radiographic Evaluation of Dental Implants Placed Using an Osteotome Technique

BACKGROUND

The osteotome technique has been successfully used for implant placement when a limited vertical height is available at posterior maxilla. However, it is not clear if new bone is formed at the apical portion of the implant placed by this technique without any bone graft. The aim of this study was to radiographically evaluate bone formation around dental implant surfaces exposed to the space created at the sinus floor without the presence of any graft material.

METHODS

Forty patients (21 male, 19 female; mean age 46.7 years) who received a total of 75 dental implants together with indirect sinus lifting procedure were included. Initial and 6-month postoperative panoramic films were scanned and analyzed using a commercially available software program. Implants were divided into two groups: initial alveolar bone height <9 mm or > or =9 mm. This helped determine the effect of available bone and exposed implant surface on bone formation in a system where the shortest implant was 8 mm.

RESULTS

The mean implant length placed at locations with <9 mm initial bone height (mean 7 +/- 1.3 mm, N = 29 implants) was 11 +/- 1.7 mm; gain in bone height was 3.9 +/- 1.9 mm. At locations where minimum bone height was 9 mm (mean 10.4 +/- 0.7 mm), 44 implants were placed with a 13.5 +/- 1.06 mm mean length. Mean gain in bone height was 2.9 +/- 1.2 mm at these sites. Two implants were lost at stage 2 surgery. The success rate after 25 months of loading was 97.3%.

CONCLUSIONS

It is possible to radiographically observe a gain of approximately 3 to 4 mm of bone from the sinus floor to the implant apex. The amount of initial alveolar bone height, presence of sinus membrane perforation, and the amount of exposed implant surface appear to play a role in the presence or absence of radiopacity within the elevated sinus floor, following 6 months of healing.

Surgical templates for prosthetically guided implant placement

The article describes a prosthetically guided method for the fabrication of surgical templates for partially edentulous patients. A number of stainless steel components are used to capture the optimal prosthetic position for the placement of the implant determined from a diagnostic arrangement. A radiopaque stainless steel guide sleeve is used to guide the drill in preparation of the osteotomy after radiographs are made to verify the position and proposed trajectory of the guide sleeve.

Surgical and prosthetic concepts for predictable immediate loading of oral implants

Immediate loading of oral implants is an established concept for lower jaw restoration using four intraforaminal implants splinted together with a bar. There is a lot of misunderstanding in the literature and not exact definition of the term "immediate loading." Moreover, the number of implants to restore edentulous jaws is relatively high to compensate for the loading forces and dependent on the bone quality and quantity. This report presents the different surgical and prosthetic concepts for immediate loading to get long-term success in the upper and lower jaw. When the primary stability is adequate, only six implants may be loaded immediately after surgery, if the implants are splinted using a provisional fixed restoration. Using a number of six primary stable implants, it is possible to restore edentulous jaws independent on the clinical situation. This concept may be used successfully in the posterior part of the mandible when three implants are splinted with provisional crowns and loaded immediately. The biomechanical aspects, the implant design and surface seem to be of great importance for the long-term success in compromised and advanced surgical cases. In conclusion, immediate loading of oral implants may be successful if a primary stability as well as immobilization (splinting) immediately after surgery are taken care.

The role of panoramic radiographs in the medical surveillance of a patient at risk for stroke: case report

Positive carotid calcifications on a panoramic radiograph were found to be in agreement with significant carotid stenosis as determined by duplex ultrasound examination. As dentists are expected to be aware of systemic health conditions that they identify while providing dental care and to refer patients for follow-up medical care, this case report may help dentists to detect incidental carotid artery calcifications on panoramic radiographs.

Oral rehabilitation with implant-supported fixed partial dentures in periodontitis-susceptible subjects. A 5-year prospective study

BACKGROUND

Comparatively few studies with at least 5 years of follow-up are available that describe the use of implants in prosthetic rehabilitation of partially edentulous patients. Randomized, controlled clinical studies that evaluated the effect of different surface designs of screw-shaped implants on the outcome of treatment are also sparse.

OBJECTIVE

To determine, in a prospective randomized, controlled clinical trial, the outcome of restorative therapy in periodontitis-susceptible patients who, following basic periodontal therapy, had been restored with implants with either a machined- or a rough-surface topography.

MATERIAL AND METHODS

Fifty-one subjects (mean age, 59.5 years), 20 males and 31 females who, following treatment of moderate-to-advanced chronic periodontitis, required implant therapy for prosthetic rehabilitation were recruited. Seventeen of the patients were current smokers. Following the active treatment, all subjects were included in an individually designed maintenance program. A total of 56 fixed partial dentures (FPDs) and a total of 149 screw-shaped, and self-tapping implants (Astra Tech implants) -- 83 in the maxilla and 66 in the mandible -- were installed in a two-stage procedure. Each patient received a minimum of two implants and by randomization every second implant that was installed had been designed with a machined surface and the remaining with a roughened Tioblast surface. Abutment connection was performed 3-6 months after implant installation. Clinical and radiographical examinations were performed following FPD connection and once a year during a 5-year follow-up period. The analysis of peri-implant bone-level alterations was performed on subject, FPD and implant levels.

RESULTS

Four patients and four FPDs were lost to the 5 years of monitoring. One implant (machined surface) did not properly integrate (early failure), and was removed at the time of abutment connection. Three implants were lost during function and a further eight implants could not be accounted for at the 5-year follow-up examination. The overall failure rate at 5 years was 5.9% (subject level), 5.3% (FPD level) and 2.7% (implant level). Radiographic signs of loss of osseointegration were not found at any of the implants during the 5-year observation period. During the first year in function there was on average 0.33 (SD, 0.61) mm loss of peri-implant marginal bone on the subject and FPD levels and 0.31 (0.81) mm on the implant level. During the subsequent 4 years, the peri-implant bone-level alterations were small. The calculated annual change in peri-implant bone level was -0.02 (0.15) on subject and FPD levels and -0.03 (0.20) on the implant level. Thus, the mean total bone-level change over the 5-year interval amounted to 0.41 mm on all three levels of analysis. In the interval between baseline and 5 years, the machined and the Tioblast implants lost on average 0.33 and 0.48 mm, respectively (p>0.05).

CONCLUSION

The present randomized, controlled clinical trial that included partially edentulous periodontitis-susceptible subjects demonstrated that bone loss (i) during the first year of function as well as annually thereafter was small and (ii) did not vary between implants with machined- or rough-surface designs.

Mandibular bone remodelling in adults: evaluation of panoramic radiographs

OBJECTIVES

To evaluate the changes in the antegonial angle, antegonial depth and gonial angle in edentulous and dentate patients in different age groups and between genders.

METHODS

We evaluated 312 panoramic radiographs selected from our files. The images were grouped into four 10-year age groups (by decades). The youngest age group was 40-49 years and the oldest 70-79 years. Gender, dentition status and age were recorded. Measurements were made by two observers.

RESULTS

No significant differences were observed for the gonial angle regarding age, gender and edentulism. For antegonial angle, the males (160.86 degrees +/-0.78) had significantly smaller values than females (165.08 degrees +/-0.58) irrespective of the dental status (P<0.0001). Edentulous individuals (161.51 degrees +/-0.83) had a smaller antegonial angle than dentate (165.05 degrees +/-0.76) and partially dentate (163.81 degrees +/-0.81) individuals (P<0.05). The antegonial depth was significantly greater for males than females (2.12 mm+/-0.09 vs 1.46 mm+/-0.07, P<0.0001). Edentulous individuals (1.87 mm+/-0.1) had significantly greater antegonial depth than dentate and partially dentate individuals (1.60 mm+/-0.1 and 1.65 mm+/-0.1, respectively).

CONCLUSION

The gonial angle did not show any change with gender, age and dental status whereas the antegonial region had a resorptive pattern in the edentulous mandible. The morphology of the antegonial region was influenced by gender and dental status.

Clinical application of a new cone-beam computerized tomography system to assess multiple two-dimensional images for the preoperative treatment planning of maxillary implants: case reports

Accurate assessment of the location of the maxillary sinuses, incisive canal, and nasal cavity, as well as the height, width, and angulation of bone is essential for implant treatment planning. The purpose of this study was to introduce the clinical application of a cone-beam computerized tomography system (Ortho-CT) to assess multiple two-dimensional (2D) images for the preoperative treatment planning of maxillary implants. To evaluate the multiple 2D images scanned using the Ortho-CT system the maxillary region placed with radiopaque template in the maxilla. Ortho-CT images provided useful information for evaluating the morphology of the maxilla, for locating the incisive canal, maxillary sinuses, nasal cavity, and for showing the relationship of the template to the bone. It is concluded that the Ortho-CT system is a useful aid for diagnosis and treatment planning for maxillary implant treatment.

Implant treatment in combination with lateral augmentation of the alveolar process: a 3-year prospective study

BACKGROUND

In patients in whom the height of the alveolar process is adequate but the crest is too narrow to host an implant, lateral augmentation is required. Such augmentations have mostly been performed using autogenous bone blocks secured to the buccal surface. An alternative to autogenous bone may be bovine hydroxyapatite (Bio-Oss, Geistlich Pharma AG, Wolhusen, Switzerland) or other bone substitutes.

PURPOSE

The aim of this study was to evaluate the clinical and radiographic outcome of dental implants inserted after lateral augmentation of too narrow alveolar processes with a combination of bovine hydroxyapatite (Bio-Oss) and autogenous bone.

METHODS

Thirty patients (14 males and 16 females) with a mean age of 41.6 years fulfilled the inclusion criteria. Twenty-nine augmentation sites with a total of 74 implants could be followed for 3 years.

RESULTS

Three implants were lost; these were lost before loading (at the abutment operation). The survival rate was 95.9%. The mean marginal bone loss during the 3-year observation period was 0.3 +/- 0.2 mm.

CONCLUSIONS

A 50/50 combination of Bio-Oss and autogenous bone chips stabilized with Tisseel (Baxter AG/Duo Quick AG, Vienna, Austria) was useful for lateral augmentation of the alveolar crest. Lateral grafts with Bio-Oss, autogenous bone, and Tisseel made it possible to achieve good implant stability and high implant survival results. The bone level changes adjacent to the implants were the same as in nongrafted cases.

A Technique for Standardized Evaluation of Soft and Hard Peri-Implant Tissues in Partially Edentulous Patients

BACKGROUND

There is a growing need to evaluate the esthetics of implant-supported crowns and bridges. An important tool for such an evaluation is standardized assessment of the soft and hard peri-implant tissue levels.

METHODS

A simple acrylic device has been developed for reliable and reproducible assessment of soft and hard peri-implant tissues using standardized color slides and standardized dental x-rays. With this device, changes in both the soft and hard tissues around implant-supported crowns can be evaluated as a function of time. The reproducibility of the technique was tested on color slides as well as on dental x-rays in a series of implant-supported crowns and their neighboring teeth.

RESULTS

The reproducibility of this technique was excellent. The measuring errors for repeated measurements of the soft and hard tissues were 0.14 +/- 0.02 mm and 0.13 +/- 0.01 mm, respectively.

CONCLUSIONS

The device is a reliable tool to assess changes in both soft and hard tissues around crowns and implants over time. Likewise, it is suggested that this technique also can be used to objectively assess soft and hard tissue changes around natural teeth with or without prosthetic restorations.

The supplementary role of panoramic radiographs in diagnosis and prevention of life-threatening systemic health condition. Case report

A 71-year-old white male had a routine panoramic radiograph taken for oral health reasons. Positive carotid calcifications findings on the radiograph were in agreement with significant carotid stenosis as determined by duplex ultrasonic examination. If the occasion arises, the authors advocate that a routine panoramic radiograph examination include an assessment of the region of the carotid system for presence of carotid calcifications in all adult patients.

A technique for making a diagnostic and surgical template

Implant-supported restorations can restore function and esthetics provided that the implants are placed in the predetermined location and properly angulated. This article describes the fabrication of a diagnostic template incorporating a silicone radiopaque marker as a guide for achieving 3-dimensional evaluation of bone without artifacts using computed tomography. The diagnostic template may be easily transformed into a surgical template by removing the silicone marker.

Implant Stability, Tissue Conditions, and Patient Self-Evaluation after Treatment with Osseointegrated Implants in the Posterior Mandible

BACKGROUND

Implant treatment in the posterior mandible is considered challenging because of bone resorption and the presence of the inferior alveolar nerve, which may result in the use of short implants.

PURPOSE

To evaluate implant stability, tissue conditions, and patient opinion after treatment with implant-supported bridges in the posterior mandible.

MATERIALS AND METHODS

Thirty-four patients treated with implant-supported bridges in the posterior mandible according to a two-stage protocol were clinically and radiographically examined and interviewed after a mean functional time of 3.9 years. One hundred five Brånemark implants (Nobel Biocare AB, Gothenburg, Sweden) were placed in premolar and molar regions to support 40 bridges. Twenty-eight implants were placed anterior to the mental foramen, and 77 implants were placed posterior to the mental foramen. Bridges were supported either by two or by three implants. After 2 to 6 years, the bridges were removed to analyze the resonance frequency of the implants with the use of a special instrument (Osstell instrument, Integration Diagnostics AB, Gothenburg, Sweden), and an implant stability quotient (ISQ) was recorded for each implant.

RESULTS

One implant was lost. An ISQ range of 59 to 90 (mean, 70.05) expressed stability of fully integrated implants in the posterior mandible. Significantly higher (p < .024) ISQ values were found in implants in three-implant bridges when compared with implants in two-implant bridges. There were no differences in ISQ values between molars/premolars, implant types, implant widths, implant lengths, anchoring depth, or uni- or bilateral mandibular bridges. Good mucosal health in the periimplant soft tissue and minor bone resorption around the implants were observed. Patients were generally very satisfied with the treatment outcome.

CONCLUSIONS

High implant stability can be reached in the posterior mandible. The implants were more stable in three-implant bridges than in two-implant bridges. The patients were highly satisfied with the treatment, and few complications were seen.

Jaw muscles in older overdenture patients

OBJECTIVE

To determine, using computer tomography (CT), whether the retention of a small number of teeth in the older adult used to support overdentures could affect the cross-sectional area (CSA) and X-ray density of two jaw closing muscles.

DESIGN

Cross-sectional study of a group of older patients subdivided into dentate, edentulous and those wearing overdentures supported by two to five teeth.

SUBJECTS

The sample consisted of 24 subjects aged 55-68 years.

OUTCOME MEASURES

CSA and X-ray density of two jaw closing muscles, masseter and medial pterygoid were measured and evaluated using CT.

RESULTS

There were no significant differences between left and right jaw muscles, but the CSA of the masseter muscles were significantly larger than the medial pterygoid muscles. The CSA of the masseter and medial pterygoid muscles was significantly smaller in edentulous subjects compared with dentate subjects but no significant difference was observed between subjects wearing overdentures and those with a natural dentition. No significant differences were observed with the X-ray density between different muscles or dental states.

CONCLUSION

The retention of a small number of teeth in the older adult used to support overdentures appears to sustain the CSA of two jaw closing muscles and therefore could enhance these patients' masticatory ability compared with those who were edentulous.

Bone regeneration by bodily tooth movement: dental computed tomography examination of a patient

A 32-year-old man was examined with computed tomography before and after orthodontic treatment, and alveolar bone levels at the edentulous spaces were assessed. When the computed tomography scans were compared, 2.2 to 5.2 mm of additional craniocaudal alveolar bone remodeling by bodily tooth movement was found in the space-opening region. Bodily movement was achieved with single- and crossed-lever-arm mechanics. Root resorption measuring 1 to 4 mm was observed at the mandibular anterior region, where teeth were used for anchorage to upright the molars.

Immediate non-occlusal loading vs. early loading in partially edentulous patients

Immediate loading of dental implants can reduce treatment time and management concerns, thus increasing patient acceptance. This paper reports the authors' preliminary experience with partially edentulous patients having received non-occlusally loaded provisional restorations within 24 hours of surgery, compared to patients treated according to an early loading protocol. The present data suggest that implant supported fixed partial prostheses can be immediately non-occlusally loaded and restored with a predictability similar to early loaded implants.

Tuned aperture computed tomography (TACT[reg ]) for cross-sectional implant site assessment in the posterior mandible

PURPOSE

This study was designed to optimize a new radiographic modality known as tuned aperture computed tomography (TACT) for cross-sectional imaging of implant sites in human dry mandibles.

MATERIALS AND METHODS

Five imaging modalities were compared for image quality and measurement accuracy: (1) conventional hypocycloidal tomograms, (2) TACT images reconstructed using the average method produced using a linear x-ray source movement, (3) TACT images reconstructed using the average method produced using a multidirectional x-ray source movement, (4) minimally reconstructed TACT images without a fiducial marker at the site of interest, and (5) minimally reconstructed TACT images with a fiducial marker at the site of interest.

RESULTS

The extended Mantel-Haenszel mean score statistic was used to investigate the influence of modality on subjective image quality. A statistically significant difference for certain types of TACT images and multidirectional tomography (P < 0.0001) was observed. Linear TACT and multmin TACT were rated as significantly better than other image modalities (P < 0.0009), whereas multidirectional tomography was rated as being significantly worse than other radiographic modalities (P < 0.0001). For the quantitative assessment, data were normalized and analyzed statistically through a paired-comparisons t test. For each modality, the accuracy for maximum height and height was significantly different from ground truth (P < 0.05).

CONCLUSION

The qualitative data suggest that visibility of structures important to the choice of implant location and dimension were seen better with certain TACT methods. Quantitative differences from ground truth (actual measurements of the bone-absolute truth) were clinically negligible. TACT appears to offer the potential of superior image quality over the status quo.

Early loading of nonsubmerged titanium implants with a sandblasted and acid-etched (SLA) surface: 3-year results of a prospective study in partially edentulous patients

PURPOSE

The aim of this study was to evaluate the success rate of ITI implants with the SLA surface that were loaded after 6 weeks of healing.

MATERIALS AND METHODS

In this prospective cohort study, a total of 104 implants were placed in posterior sites of 51 partially edentulous patients exhibiting bone densities of Class 1, 2, or 3. After a healing period of 6 weeks, all implants were functionally loaded with cemented crowns or fixed partial dentures. The patients were recalled at 3, 12, 24, and 36 months for clinical and radiographic examination.

RESULTS

One implant failed to integrate during healing, and 1 implant was lost to follow-up and considered a dropout. The remaining 102 implants showed favorable clinical and radiographic findings and were considered successfully integrated at the 3-year examination. This resulted in a 3-year success rate of 99.03%.

DISCUSSION

The peri-implant soft tissues were stable over time, as evidenced by no changes in the mean probing depths and the mean attachment levels during the follow-up period. None of the radiographs exhibited signs of continuous peri-implant radiolucency, which confirmed ankylotic stability of all 102 implants. The radiographic evaluation of the bone level at the implant indicated stability of the bone crest levels.

CONCLUSION

The results of this prospective study demonstrated that early loading of ITI implants with the SLA surface after an unloaded healing period of 6 weeks provided successful tissue integration with high predictability, and that successful tissue integration was well maintained up to 3 years of follow-up in this study population.

Early function of splinted implants in maxillas and posterior mandibles using Brånemark system machined-surface implants: an 18-month prospective clinical multicenter study

BACKGROUND

There are limited clinical data available for immediately or early loaded implants placed in posterior mandibles and maxillas. This is probably because bone density often is low in these areas, making it difficult to establish good initial implant stability. By eliminating countersinking and using slightly tapered implants (Brånemark System , Mk IV, Nobel Biocare AB, Gothenburg, Sweden), however, high initial implant stability might be achieved in these regions.

PURPOSE

The aim of this study was to investigate the possibility of early application of implant function in oral locations where the bone density is often low, namely the maxilla and posterior mandible.

MATERIALS AND METHODS

Thirty-one patients were included consecutively in the study, and 36 edentulous areas in maxillas and posterior mandibles were treated. All patients were nonsmokers in good general health. Bruxism and uncontrolled periodontal disease were exclusion criteria. One hundred twenty-four machined-surface implants were placed using an insertion torque of at least 40 Ncm. Temporary prostheses with narrow occlusal platforms, flat cusps, and light occlusal contacts were generally placed within 1 week and not exceeding 20 days from implant placement.

RESULTS

Of the 124 implants installed, 4 failed, 1 in each of four patients, giving an overall survival rate of 96.8% after 18 months. Two implants failed in maxillas and two in mandibles. One implant in a maxilla and one in a mandible were lost in an early stage, and the other two were lost a few months after placement. The prostheses' survival was 100%.

CONCLUSIONS

This study shows that early implant function rehabilitation in maxillas and posterior mandibles is viable using the present clinical protocol. The results are comparable with those of conventional two-stage protocols.