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      Immediate vs. early loading of SLA implants in the posterior mandible: 5-year results of randomized controlled clinical trial.

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          Abstract

          The aim of this study was to compare clinical results of immediate and early loading (EL) self-tapping implants placed in posterior mandibles.

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          Most cited references21

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          Intra-Osseous Anchorage of Dental Prostheses:I. Experimental Studies

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            Bone response to unloaded and loaded titanium implants with a sandblasted and acid-etched surface: a histometric study in the canine mandible.

            Many dental clinical implant studies have focused on the success of endosseous implants with a variety of surface characteristics. Most of the surface alterations have been aimed at achieving greater bone-to-implant contact as determined histometrically at the light microscopic level. A previous investigation in non-oral bone under short-term healing periods (3 and 6 weeks) indicated that a sandblasted and acid-etched titanium (SLA) implant had a greater bone-to-implant contact than did a comparably-shaped implant with a titanium plasma-sprayed (TPS) surface. In this canine mandible study, nonsubmerged implants with a SLA surface were compared to TPS-coated implants under loaded and nonloaded conditions for up to 15 months. Six foxhound dogs had 69 implants placed in an alternating pattern with six implants placed bilaterally in each dog. Gold crowns that mimicked the natural occlusion were fabricated for four dogs. Histometric analysis of bone contact with the implants was made for two dogs after 3 months of healing (unloaded group), 6 months of healing (3 months loaded), and after 15 months of healing (12 months loaded). The SLA implants had a significantly higher (p < 0.001) percentage of bone-to-implant contact than did the TPS implants after 3 months of healing (72.33 +/- 7.16 versus 52.15 +/- 9.19; mean +/- SD). After 3 months of loading (6 months of healing) no significant difference was found between the SLA and TPS surfaced implants (68.21 +/- 10.44 and 78.18 +/- 6.81, respectively). After 12 months of loading (15 months of healing) the SLA implants had a significantly greater percentage (p < 0.001) of bone-to-implant contact than did the TPS implants (71.68 +/- 6.64 and 58.88 +/- 4.62, respectively). No qualitative differences in bone tissue were observed between the two groups of implants nor was there any difference between the implants at the clinical level. These results are consistent with earlier studies on SLA implants and suggest that this surface promotes greater osseous contact at earlier time points compared to TPS-coated implants.
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              Implant stability measurement of delayed and immediately loaded implants during healing.

              The purpose of the present study was (1) to measure the primary stability of ITI implants placed in both jaws and determine the factors that affect the implant stability quotient (ISQ) determined by the resonance frequency method and (2) to monitor implant stability during the first 3 months of healing and evaluate any difference between immediately loaded (IL) implants and standard delayed loaded (DL) implants. The IL and DL groups consisted of 18 patients/63 implants and 18 patients/43 implants. IL implants were loaded after 2 days; DL implants were left to heal according to the one-stage procedure. The ISQ was recorded with an Osstell apparatus (Integration Diagnostics AB, Gothenburg, Sweden) at implant placement, after 1, 2, 4, 6, 8, 10 and 12 weeks. Primary stability was affected by the jaw and the bone type. The ISQ was higher in the mandible (59.8+/-6.7) than the maxilla (55.0+/-6.8). The ISQ was significantly higher in type I bone (62.8+/-7.2) than in type III bone (56.0+/-7.8). The implant position, implant length, implant diameter and implant deepening (esthetic plus implants) did not affect primary stability. After 3 months, the gain in stability was higher in the mandible than in the maxilla. The influence of bone type was leveled off and bone quality did not affect implant stability. The resonance-frequency analysis method did not reveal any difference in implant stability between the IL and DL implants over the healing period. Implant stability remained constant or increased slightly during the first 4-6 weeks and then increased more markedly. One DL and IL implant failed; both were 8 mm long placed in type III bone. At the 1-year control, the survival rate of the IL and the DL implants was 98.4% and 97.7%, respectively. This study showed no difference in implant stability between the IL and DL procedures over the first 3 months. IL short-span bridges placed in the posterior region and full arch rehabilitation of the maxilla with ITI sandblasted-and-etched implants were highly predictable.
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                Author and article information

                Journal
                Clin Oral Implants Res
                Clinical oral implants research
                Wiley
                1600-0501
                0905-7161
                Feb 2014
                : 25
                : 2
                Affiliations
                [1 ] College of Dental Science, Ras Al Khaimah, UAE.
                Article
                10.1111/clr.12072
                23278375
                5f67998a-3fa3-4066-9f90-60f084e5c336
                © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.
                History

                early loading,immediate loading,implant stability,peri-implant bone resorption,resonance frequency analysis

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