Crestal bone changes around early vs. conventionally loaded implants with a multi-phosphonate coated surface: A randomized pilot clinical trial

Cumulative success rate and marginal bone loss for immediate and early loading protocols in a single implant-supported crown: A randomized controlled split-mouth clinical trial

STATEMENT OF PROBLEM

New loading protocols with reduced treatment time have gained popularity because of their advantages. However, whether the success rate with immediate loading (IL) is worse than with early loading (EL) is still unclear.

PURPOSE

The purpose of this randomized controlled trial with a split-mouth design was to evaluate the marginal bone loss and the cumulative success rate (CSR) 1 year after an IL protocol in single implant-supported crowns. The test groups were loaded after less than 24 hours (test group) and EL at 60 days (control group).

MATERIAL AND METHODS

Seventeen participants received 34 implants. The recall appointments were at baseline, 30 days, 60 days, and 1 year. The outcome measures evaluated were pain, implant clinical mobility, probing depth measurements, peri-implant disease, marginal bone loss, implant insertion torque, implant stability quotient (ISQ) value, and the CSR. A 2-way repeated measures ANOVA identified the significant differences for probing depth and ISQ. A 3-way repeated measures ANOVA followed by a pairwise t test analyzed marginal bone loss, and a nonparametric Wilcoxon test analyzed insertion torque (α=.05).

RESULTS

No differences were found between the insertion torque, ISQ, and marginal bone loss values (P>.05). When analyzing probing depth, no differences were found when comparing IL versus EL at baseline, 30 days, and 1 year (P>.05). The global CSR was 91.17%, 88.23% for the IL group and 94.11% for the EL group.

CONCLUSIONS

When analyzing marginal bone loss, the groups were similar. The global CSR was 91.17%, 88.23% for the IL group, and 94.11% for the EL group.

Clinical efficacy of early and delayed loading implants: A systematic review and meta-analysis

STATEMENT OF PROBLEM

Whether early loaded implants have similar clinical outcomes to delayed loaded implants is unclear.

PURPOSE

The purpose of this systematic review and meta-analysis was to compare the outcomes of early and delayed loading dental implants.

MATERIAL AND METHODS

Comprehensive searches of the MEDLINE, EMBASE, and Ovid databases were enriched by hand searches. Only human randomized controlled trials (RCTs) that compared the clinical efficacy of early and delayed loading were included. The survival rates and marginal bone level (MBL) changes were pooled and analyzed by risk ratios (RRs) and weighted mean differences (WMDs), respectively. The subgroup analyses, which were based on the Mantel-Haenszel and inverse-variance methods, included the types of prosthesis, implant time, occlusion, number of missing teeth, operation methods, dental position, healing methods, and type of first restoration. A funnel plot was used for heterogeneity analysis.

RESULTS

Eighteen trials were included from the initial 601 articles. The dental implant survival rates for the early and delayed loading were similar (P>.05). Regarding the marginal bone level changes, the 2 loading protocols also reached a comparable clinical outcome (P>.05).

CONCLUSIONS

Early implant loading should achieve the same clinical efficacy as the delayed loading method.