Ten-year follow-up of dental implants used for immediate loading in the edentulous mandible: A prospective clinical study.

PURPOSE: The purpose of this study is to evaluate the 10-year outcome of 25 patients with immediate loading in the edentulous mandible. MATERIAL AND METHODS: Twenty-five patients were consecutively treated with 5 immediately loaded fluoride-modified implants in the edentulous mandible. Implant survival and bone loss were evaluated by an external researcher comparing digital periapical radiographs taken during recall visits with baseline (at implant insertion). Statistical descriptive analysis and nonparametric tests were performed using SPSS v23, multilevel analysis was performed by means of R version 3.1.0. to identify risk factors for bone loss. RESULTS: Twenty-one patients (8 males, 13 females, mean age 68.4, range 49-84) responded to the 10-year recall invitation. No implants were lost during follow-up, resulting in a 100% survival rate. After 10 years, bleeding on probing and plaque were present at 49.5% and 67.6% of the sites, respectively. The mean pocket probing depth was 3.77 mm (SD 0.73, range 3.0-6.83). Bone loss on implant level after 3, 12, 24, and 120 months was 0.16 mm (SD 0.33, range 0-1.75), 0.14 mm (SD 0.24, range 0-1.05), 0.17 mm (SD 0.27, range 0-1.5), and 0.49 mm (SD 1.08, range 0-7.8). Five implants were identified with or at risk for progressive bone loss. Forty-seven percent of the implants did not show any bone loss after 10 years in function and 87% lost less than 1 mm. Multilevel statistical analysis identified 2-year bone loss as a predictor for bone loss after 10 years of function. CONCLUSION: Immediate loading of 5 fluoride-modified dental implants with a fixed prosthetic rehabilitation is a predictable and reliable treatment in the edentulous mandible, based on a 100% implant survival and limited peri-implant bone loss. Implants used for immediate loading in the edentulous mandible who are showing early bone loss may be at higher risk to develop peri-implantitis.

A 2-year prospective study on immediate loading with fluoride-modified implants in the edentulous mandible.

OBJECTIVES: Chemically modified surfaces were introduced during the last decade to improve indications for implant treatment. The fluoride-modified implant (Osseospeed(®)) was launched in 2004 and clinical studies suggest a more rapid bone formation and stronger bone to implant contact. However, limited clinical data are available on marginal bone loss and the outcome after >1 year under immediate loading conditions is not fully understood. Hence, the purpose of this prospective study was to present implant survival and marginal bone level data when fluoride-modified implants are supporting a fully functional rehabilitation from the day after surgery in the completely edentulous mandible. MATERIALS AND METHODS: Twenty-five patients, completely edentulous in the mandible, were consecutively treated with five fluoride-modified implants that were functionally loaded with a provisional screw retained restoration. Marginal bone loss was measured from day of surgery to 3, 6, 12 and 24 months. Implants were considered successful after 24 months if radiographic bone loss did not exceed 1 mm and no pain or mobility was caused under a torque of 20 N cm. Statistical analysis was carried out on both patient and implant levels. RESULTS: All implants survived and mean bone loss on implant level after 3, 6, 12 and 24 months was 0.14, 0.13, 0.11 and 0.11 mm, respectively. Bone loss was only statistically significant between baseline and 3 months (P<0.001) and remained unchanged afterward. None of the implants lost >1 mm of bone after 2 years. On the patient level, the mean bone loss after 2 years was 0.12 mm (SD 0.14; range -0.06 to 0.55) with probing pocket depth 2.45 mm (SD 0.43; range 1.3-3.1) and bleeding index 0.55% (SD 0.34; range 0-1). CONCLUSION: Immediate loading of fluoride-modified implants is a predictable treatment yielding a high survival and success rate after 2 years.