Loading protocols for dental implants in edentulous patients.
ABSTRACT The objective of this systematic review was to present the current scientific and clinical evidence related to implant-supported rehabilitations for the edentulous mandible and maxilla.
An electronic search of several databases covered the period from January 1966 to August 2008. From a total of 2,371 publications identified from this search, 61 articles fulfilled the inclusion criteria set forth by the authors. It should be noted that only studies reporting on implants with rough surfaces were included in the final selection for this review.
Selected studies yielded data from 2,278 patients and 9,701 implants. Studies were grouped according to treatment protocol and prosthodontic design, and results on conventional, early, and immediate loading were assessed separately for fixed and removable dental prostheses. Clinical recommendations for implant loading in different edentulous indications were established using a special validation protocol of the published scientific and clinical evidence for different treatment modalities, which was based on the study design, sample size, and outcome homogeneity between studies.
The highest level of scientific and clinical validation was found for conventional loading with mandibular overdentures and maxillary fixed dental prostheses. Insufficient scientific or clinical documentation/validation was found for immediate loading of maxillary overdentures, as well as for immediate loading of immediately placed implants combined with fixed or removable dental prostheses in either jaw. All other loading protocols for edentulous arches showed different degrees of clinical documentation.
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ABSTRACT: Background To assess the suitability of dental implants for immediate loading, primary stability is usually evaluated intraoperatively.PurposeThis retrospective study aimed to assess the suitability of three stability parameters – namely, insertion torque (IT), implant stability quotient (ISQ; measured by resonance frequency analysis), and Periotest (PT) values – as potential predictors for the risk of nonosseointegration of immediately loaded splinted implants. The stability parameters were routinely collected under immediate loading.Materials and Methods Nineteen patients with 11 edentulous and 8 partially edentulous maxillae were treated with 105 dental implants, which were immediately loaded using temporary fixed dentures. The IT results, PT values, and ISQ results were recorded. Receiver operating characteristic analysis was performed to assess the quality of each parameter as a diagnostic test.ResultsAfter a 3-month observation period, 11 implants in four patients were not osseointegrated. The IT and ISQ (IT 25.0 ± 12.5 Ncm and 8.4 ± 2.3 Ncm; PT −1.5 ± 3.0 and +2.7 ± 3.0; and ISQ 62.6 ± 6.7 and 54.7 ± 6.2) differed significantly between the osseointegrated and failed implants (p < .005). The IT showed the greatest specificity at a sensitivity of 1 and the greatest area under the curve (AUC; 0.929), followed by the PT value (AUC = 0.836) and ISQ (AUC = 0.811).Conclusions Among the intraoperative parameters analyzed, IT showed the highest specificity at a high sensitivity of 1. Therefore, the IT can be considered the most valid prognostic factor for osseointegration of immediately loaded splinted dental implants.Clinical Implant Dentistry and Related Research 01/2015; · 3.82 Impact Factor
- European Journal of Inflammation 08/2012; 10(2 - Supplement):13-16. · 0.99 Impact Factor
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ABSTRACT: O grande desenvolvimento do protocolo de carga imediata configura-se da redução do tempo de tratamento clínico, em uma única etapa cirúrgica. Institui-se, em um curto espaço de tempo, as necessidades estéticas e funcionais do paciente, além de melhorar a autoestima e satisfação.O objetivo deste trabalho é discutir através de dois casos clínicos, o sucesso e fracasso da técnica de carga imediata de protocolos e considerar a importância do cantlever.Revista catarinense de odontologia 01/2014;