Instantaneous dental implant loading technique by fixed dentures: A retrospective cohort study.

BACKGROUND: In the context of dental prostheses, splinting multiple implants together may improve their stability. The approach may be especially favorable when performing immediate loading procedures, increasing the implant osseointegration rate, and reducing the risk of implant and prosthetic failure. The instantaneous loading technique (ILT) involves creating a metal framework to splint the implants by intraorally welding them pair-by-pair, using purposefully created abutments. OBJECTIVES: The aim of the study was to investigate the prosthetic success when using ILT to rehabilitate partially edentulous patients through immediately loaded prostheses. MATERIAL AND METHODS: Clinical records of patients treated with ILT were retrospectively assessed, and the prosthetic success rate was analyzed in terms of fractures, chipping, unscrewing, screw fracture rate, and mucositis. Furthermore, the implant success rates were evaluated by measuring marginal bone loss (MBL). RESULTS: A total of 55 patients (20 males and 35 females with a mean age of 59.8 ±9.4 years), corresponding to 66 prostheses, were included. A total of 160 implants were placed. At the last follow-up (39.6 ±28.4 months), 1 patient (1.8%; 1 prosthesis (1.5%)) showed the fracture of the prosthesis material. Peri-implantitis affected 4 implants (2.5%), and 4 more implants (2.5%) showed radiolucency, affecting 5 patients (9.1%). Two other patients (3.6%) suffered from mucositis. The implant success rate, according to the Albrektsson and Zarb criteria, was 94.4%. No implants were lost. The mean MBL values at the implant level, the prosthesis level and the patient level were 0.28 ±0.56 mm, 0.30 ±0.51 mm and 0.33 ±0.54 mm, respectively. CONCLUSIONS: The instantaneous loading technique appears to be a viable approach to rehabilitating partially edentulous patients through immediate loading.

Intraorally welded wing abutments supporting full-arch prostheses: A retrospective clinical study.

BACKGROUND: Delayed loading in the rehabilitation of edentulous patients with an implant-supported prosthesis implies a longer treatment time. It requires additional surgery to uncover the submerged implants, and this may increase patients' discomfort and morbidity. OBJECTIVES: The immediate loading-based technique described in this article involves creating a metal framework by intraorally welding the implants pair by pair, using specific wing abutments. The aim of the study was to investigate the implant-prosthetic success and complication rates of this technique when used to rehabilitate totally edentulous patients. MATERIAL AND METHODS: The clinical records of totally edentulous patients were retrospectively evaluated. The prosthetic success rate as well as technical and biological complications were analyzed. Furthermore, the implant survival and success rates were assessed by measuring marginal bone loss (MBL) at the implant, prosthesis and patient levels. RESULTS: The records of 37 patients (284 implants and 43 prostheses) were included in the study. At the last follow-up (45.5 ±33.6 months), the prosthetic success rate was 100%. Mucositis affected 4 implants (1.4%), while peri-implantitis affected 4 implants (1.4%). Meanwhile, 7 implants (2.5%) showed a lack of early osseointegration. According to the criteria of Albrektsson et al., 271 implants (95.4%) were successful. The average MBL at the implant, prosthesis and patient levels was 0.26 ±0.42 mm, 0.26 ±0.19 mm and 0.26 ±0.18 mm, respectively. CONCLUSIONS: The technique described in this article seems to be a viable approach to the rehabilitation of totally edentulous patients through immediate loading. However, these results should be confirmed by appropriately designed prospective and comparative clinical studies.

Influence of abutment height and vertical mucosal thickness on early marginal bone loss around implants: A randomised clinical trial with an 18-month post-loading clinical and radiographic evaluation.

PURPOSE: To investigate the influence of vertical mucosal thickness on marginal bone loss around implants with short and long prosthetic abutments and the marginal bone loss progression rate up to 18 months after prosthetic loading. MATERIALS AND METHODS: Internal hex platform-switched implants were placed equicrestally using a two-stage protocol in the posterior mandible of two groups of patients with different vertical mucosal thickness, thin (≤ 2.0 mm) and thick (> 2.0 mm). Elevated prosthetic abutments of different heights (1 mm or 3 mm) were randomly assigned for single screw-retained crowns in both groups. Mesial and distal marginal bone loss were measured at implant placement (T0) and crown delivery (after 4 months [T1]), and after 6 (T2), 12 (T3) and 18 months (T4) of functional loading. RESULTS: Eighty implants were placed in eighty patients. Three patients dropped out at T2. At T4, 74 out of 77 implants were functioning, resulting in a 96% survival rate. Marginal bone loss (mean ± SE) at T2 was significantly greater in the 1-mm abutment groups (0.61 ± 0.09 mm with thin mucosa; 0.64 ± 0.07 mm with thick mucosa) than in the 3-mm abutment groups (0.32 ± 0.07 mm with thin mucosa; 0.26 ± 0.04 mm with thick mucosa). The marginal bone loss pattern over 18 months of loading showed that the greatest amount of marginal bone loss occurred during the first 6 months of function. CONCLUSIONS: Internal hex platform-switched implants placed equicrestally and restored with 1-mm abutments presented greater marginal bone loss than identical implants with 3-mm abutments, with vertical mucosal thickness having no significant influence.