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ORIGINAL STUDY
Issue: 03/2011 - P. Gehrke - H. Schliephake - D. Siebers
Immediate Function in a Dental Practice

Objectives: The aim of this study was to clarify whether immediate function or immediate loading in a private practice may be regarded as a safe treatment protocol for selected cases. This question is addressed using a longitudinal case control study of patients in a private practice.

Material and Methods: All 111 implants that had been treated according to an immediate function protocol between 2001 and 2004 were followed up. 111 implants with parameters as similar as possible served as controls. 96 parameters in 76 patients were recorded and analyzed. These included numerous risk factors mentioned in the literature, implant and denture parameters, and clinical and radiographic parameters. The implant success rate was evaluated and an aesthetic assessment of a reasonable proportion was performed.

Results: Five of the 222 implants were lost during the healing period (survival rate 97.7% after 3.25years on average). The Kaplan-Meier analysis showed statistically significantly better results for the control group (survival rate 100%) compared with the test group (survival rate 95.5%, p=0.024) as well as for implantation in healed sites (99.4%, p=0.0055) compared with immediate implantation (93.1%). Evaluation of implant success resulted in a success rate of 97.75% (Gettleman/Schnitman) and 95.5% (Buser/Naert). The success rate was statistically significantly higher with delayed compared with immediate implantation (p=0.017). The test group had significant advantages aesthetically compared with the control group (p=0.0074).

There were also advantages for immediate compared with delayed implantation (p=0.0076) and for the test group compared with the control group (p=0.0092). The probing depth was less in the test group than in the control group (p=0.011) and with immediate loading compared with the immediate restoration group (p=0.025).

Conclusions: Immediate function of dental implants is a therapy with a high success rate of 95.5% and high aesthetic potential. However, there is evidence that immediate function and immediate implantation are associated with a higher risk of failure. Therefore, an accurate risk analysis is required for each patient to avoid risk accumulation.

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Issue: 02/2009 - H. Schliephake - E. Nkenke
Immediate loading and immediate restoration of oral implants: indications and survival rates

Based on an analysis of the current literature, the aim of the study was to compare the survival rate of immediately loaded implants with implants loaded after an unloaded healing period.

The literature search was performed electronically. Medline and Embase were searched from 1966 to 2006. The keywords were dental implant, delayed loading, immediate loading, immediate restoration, mandible, maxilla, edentulous, oral implant, partially dentate and single-tooth in different combinations.

The results of the literature analysis show that there is evidence based on prospective randomised controlled clinical trials that immediate loading of dental implants yields survival rates that are comparable to those of implants which are loaded after an unloaded healing period. These results are found in the mandible as well as in the maxilla and in edentulous, partially dentate and single-tooth situations. The lowest survival rate for immediate loading was 81.2 %, found after twelve months for single-tooth situations in the maxilla. For the remaining situations the survival rate exceeded 95 % after twelve months.

The analysis of the literature shows that immediate loading is well established in implant dentistry for all indications. In the future it will be important to define valid criteria that allow safe patient selection for immediate loading.

Keywords: Immediate loading, immediate restoration, dental implant, unloaded healing

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