implants international magazine of oral implantology

I industry report Fig. 1_Case before treatment. Fig. 2_Implant insertion: SEVEN and Mistral implants are inserted flaplessly. _Introduction Immediateloadingoforalimplantshasbeendefined asasituationinwhichthesuperstructureisattachedto theimplantsnolaterthan72hoursaftersurgery(Apari- cioetal.2003;Cochranetal.2004).Thedefinitionofim- mediate loading also includes occlusion with the teeth oftheoppositejaw.Undertheseconditions,successful immediate loading of screw-type dental implants was reportedasearlyas1979(Ledermann1979). The proposed exclusion criteria include insufficient bone volume, severe maxillo-mandibular skeletal dis- crepancy,drugandalcoholabuse,heavysmoking,local radiotherapyoftheheadandneckregionformalignan- cies, uncontrolled diabetes, stroke, recent infarction, pregnancyatthetimeofevaluation,bleedingdisorders or coumarin therapy, metabolic disorders, and general contra-indications for surgical procedures (Chiapasco etal.2001;Chowetal.2001;Huietal.2001;Proussaefs etal.2002;Jaffinetal.2004;Proussaefs&Lozada2004; Ibanezetal.2005). The question of reducing the micro-movement has not yet been addressed in controlled studies dealing withtheimmediateloadingoforalimplants.Passivefit ofprovisionalprostheseshasbeenmentionedasanim- portant factor in the osseointegration of immediately loaded implants. A prosthesis that is ill fitting may be- come loose, resulting in increased stress on the im- plants, which can lead to excessive micromotion and thelossofanimplant(Jaffinetal.2004).Inthiscontext, ithasbeenhypothesisedthatscrew-retained,passively fittingrestorationsmaybesuperiortocement-retained oneswithrespecttothisproblembecausetheyareless likely to become loose. If a cemented restoration is de- sired,theabutmentsshouldbelongenoughtoprovide adequateretention(Jaffinetal.2004). Theultimategoalofanimmediateloadingprotocol is to reduce the number of surgical interventions and shortentheperiodbetweensurgeryandprostheticde- livery,withoutsacrificingimplantsuccessrates. _Material and methods The study was performed in two clinical centres by two investigators who followed the same clinical pro- tocol for immediate occlusal loading of implants placedintheedentulousmandibleormaxilla. Thirty patients were enrolled in the study. Of these patients, ten maxillas and ten mandibles were treated with six implants and five implants, respectively, for a totalof110implantsasthetestgroupforscrewedim- plants, and ten patients (five maxillas and five mandibles) were the control group for cemented im- plants, with a total of 55 implants inserted. All of the patients were edentulous in the maxilla and/or Screwed versus cemented immediately functionally loaded implants A five-year prospective analysis Author_Dr Luca Di Alberti1 , Prof Dario Bertossi2 , Prof Lorenzo Lo Muzio1 & Prof Pierfrancesco Nocini2 , Italy 30 I implants2_2012 Fig. 1 Fig. 2