Immediate occlusal loading of Brånemark implants applied in various jawbone regions: a prospective, 1-year clinical study.
BACKGROUND: The original protocol for dental implant treatment ad modum Brånemark was based on submerged healing prior to loading. For patients, immediate implant function could reduce cost and increase attractiveness of implant treatment. PURPOSE: The goal of this study was to evaluate the short-term success rate of immediately loaded implants placed in various regions of the jaws. MATERIALS AND METHODS: Forty-one patients received a total of 127 immediately loaded implants (76 maxillary and 51 mandibular). Seventy-one percent of the patients received their prosthetic restoration the same day and the others within 11 days. All prosthetic constructions were in full contact in centric occlusion. Clinical follow-up examinations were performed at 1 week, 2 weeks, and at 1, 2, 3, 6, and 12 months after implant loading. The study was completed 1 year after loading. RESULTS: Twenty-two implants were lost in 13 patients (including 7 maxillary implants lost in 1 patient). The cumulative success rate of the implants was 82.7% after 1 year of prosthetic loading. All sites with implant losses were re-implanted, using a two-stage technique, with no further complications reported. Ninety-one percent of implants placed in regions other than the posterior maxilla were successful compared with 66% of implants placed in the posterior maxilla. Implants in patients with a parafunctional habit (bruxers) were lost more frequently than those placed in patients with no parafunction (41% vs. 12%). Implants subjected to guided bone regeneration were more successful compared with those not subjected to regeneration procedures (90% vs. 67%). CONCLUSIONS: The immediate loading concept is a realistic treatment alternative in various jawbone regions except for the posterior part of the maxilla. High occlusal loads should be considered a risk factor. On the other hand, implants in combination with bone defects frequently are penetrating cortical layers to a higher extent, thereby contributing to implant stability during the healing phase and consequently do not inevitably jeopardize the treatment result. However, further controlled clinical studies with larger sample sizes need to be performed to evaluate the influence of different parameters on treatment outcome.