implants international magazine of oral implantology

I industry report Fig. 6_Three of the six implants after three months of occlusal loading with a cemented provisional bridge. Fig. 7_Six implants inserted in the maxilla and ready for cemented bridge. Fig. 8_Cemented bridge with occlusal loading at time of surgery. _Discussion Earlyloadinghasbeenmadepossiblebyusingtex- tured surfaces that promote osseointegration (Buser etal.1991;Cochranetal.1998;Trisietal.1999;Testori et al. 2002). However, immediate occlusal loading procedures can be successful only when the amount ofmicromotionatthebone–implantinterfaceiskept below a certain threshold during the healing phase (Szmukler-Moncler et al. 1998). It is widely accepted thatimmediateloadingisadesirableprocedureifthe outcome in terms of implant survival and success is comparable to that of conventional loading. There- fore, it has been the aim of the present study to demonstrate the different clinical outcomes and in- dications for cemented versus screwed immediately loadedprostheticappliances,toassessthelevelofev- idence and to discuss implant survival rates and the success rates of these two different protocols. Varying experiences in the immediate occlusal loading of oral implants has led to different consen- sus papers (Aparicio et al. 2003; Cochran et al. 2004; Misch et al. 2004). In many of the studies on immedi- ateloading,goodbonequalityismentionedasanim- portant prognostic factor for the success of the pro- cedure (Chiapasco et al. 2001; Romeo et al. 2002). Al- though this conclusion appears reasonable, the level of evidence supporting the assumption is low. The same holds true for the implant lengths and diame- ters that should be used for immediate loading. In a controlled study, rough implant surfaces improved the survival rate of immediately loaded implants (Rocci et al. 2003); however, the influence of the rough as opposed to machined surfaces was not sig- nificant. Several authors have addressed their interest on the biomecanical aspects of the occlusion in the im- mediate loading protocol (Szmukler-Moncler et al. 2000; Gapski et al. 2003; Chiapasco et al. 2004). It is commonly accepted, since the study of Cameron in 1971,that amicromotionlimitof150micronsshould not be exceeded (Maniatopoulos et al. 1986; Pilliar et al. 1986; Szmukler-Moncler et al. 1998). It has been shown that this limit could be controlled using tex- turedsurfaceandimmediatestabilityoftheimplants (Chaushu et al. 2001; Calandriello et al. 2003). The protocol of immediate loading linking the immediate stability with a metal reinforced provisional prosthe- sis screwed on multiunit abutments was successful and has been in previous reports (Nikellis et al. 2004; Van Steenberghe et al. 2004). _Conclusion All study patients received provisional prosthesis within four hours of surgery, and their final rehabili- tation was completed six months later. The fact that patients could wear a fixed prosthesis since the first day of surgery has enhanced the compliance of the patients for the treatment period. The marginal bone defects around immediately loaded implants were similar to delayed loading pro- tocols(Albrektssonetal.1986).However,severalclin- ical studies on immediately loaded implants have clearlyconfirmedthatthefirstsixmonthsofocclusal function are crucial (Babbush et al. 1986; Schnitman etal.1990;Balshi&Wolfinger1997;Schnitmanetal. 1997; Ericsson et al. 2000; Jaffin et al. 2000; Szmuk- ler-Moncler et al. 2000; Chaushu et al. 2001). We can conclude that immediate loading protocol using multi-unit abutments is a reliable technique._ 32 I implants2_2012 Fig. 7 Fig. 8Fig. 6 Dr Luca Di Alberti Department of Dental Sciences University of Foggia Via Colonnetta 22-A 66013 Chieti Italy dialbertiluca@yahoo.it 1 Department of Dental Sciencies, University of Foggia,Italy 2 Department of Oral and Maxillofacial Surgery, University ofVerona,Italy _contact implants