Immediate loading in oral implants. Present situation.
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The earliest antecedents of immediate loading were introduced by Ledermann in 1979. He placed overdenture in four interforaminal implants on the same day the surgery was carried out. In the original implantological protocol of Branemark the immediate loading did not appear indicated, currently, it is being presented as a predictable alternative in several studies. We revised different articles on immediate loading from 1997 to 2002. We analysed different variables and concluded that immediate loading produces a success rate in posterior maxilla similar to the differed loading (90-100%). The characteristics of the implant, favourable to immediate loading, are: screw-shaped, with a rough surface, sand blasted and acid etching processed and a minimum length of 10 mm. The initial stability and a micro movement of the implant, inferior to 150 microm and a marginal to the insertion equal or superior to 32 N/cm are defined as a proper osseous. The bruxism stands out as an adverse factor according to several authors. (+info)
Immediate loading of two unsplinted mandibular implants in edentulous patients with an implant-retained overdenture: an observational study over two years.
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OBJECTIVES: Immediate loading of two unsplinted mandibular implants by means of an overdenture may be a viable and cost-effective treatment option to improve the patient's oral health-related quality of life. We therefore conducted a prospective observational study to estimate implant survival and patient satisfaction after an immediate loading protocol in edentulous patients. MATERIALS AND METHODS: Twenty edentulous patients who received two interforaminal implants (Straumann Standard implant, length 12 mm) were included in our study. Immediately after implant placement, ball attachments with a diameter of 2.25 mm were placed on the implants and the respective matrices were directly incorporated in the existing complete denture. Clinical recalls were scheduled 1 week, 1, 3, 6 months, and 1 and 2 years after implant placement. The following clinical parameters were assessed: gingival bleeding index (GBI), visual plaque index (VPI), and soft tissue overgrowth. In addition, we also assessed radiological bone level change (RBLC) using panoramic radiographs, and patient satisfaction using a visual analogue scale at baseline, after 6 months and 2 years. RESULTS: No implant failures occurred during the 2-year observation period, resulting in a survival rate of 100%. The mean RBLC was 0.67 mm (95% Confidence Interval [95% CI]: 0.47-0.86 mm) two years after surgery. The GBI and VPI after two years were 24 (95% CI: 9-38)% and 36 (95% CI: 19-53)%, respectively. Soft tissue overgrowth was 1.6 mm (95% CI: 1.1-2.1) on average after two years. In a multivariate regression model, patients with a GBI >/=50% on average showed an increased RBLC (-0.6 mm, p = 0.007). High patient ratings were recorded for overall satisfaction. Overall patient satisfaction measured on a scale between one and ten was 5.2 (95% CI: 2.1-8.5) before implant placement and 9.5 (95% CI: 9.1-10) after 2 years. CONCLUSION: Immediate loading of two unsplinted interforaminal implants in overdenture patients using ball attachments is a clinically viable treatment option that leads to a high survival rate and oral health-related quality of life. (+info)
Intraoral framework pick-up technique to improve fit of a metal-resin implant prosthesis.
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