Immediately restored one-piece single-tooth implants with reduced diameter: one-year results of a multi-center study.

OBJECTIVES: The aim of the present multi-center study was to evaluate the treatment outcome of immediately restored one-piece single-tooth implants with a diameter of 3 mm after 1 year. MATERIAL AND METHODS: A total of 57 one-piece implants (NobelDirect 3.0) were inserted in 47 patients (26 females, 21 males) with a mean age of 31 years (range: 17-76 years) at five different centers. The implants replaced maxillary lateral incisors and mandibular incisors. The implants were placed either in conjunction with tooth extraction or in healed sites, and all implants were immediately restored with a provisional resin crown. If needed, the abutment part of the implant was prepared before crown cementation. The permanent crown was placed after 1.9-14.5 months. Radiographs were taken at implant insertion as well as after 6 and 12 months to evaluate the peri-implant marginal bone level and bone loss. Moreover, plaque, bleeding on probing and complications were assessed. RESULTS: A total of 44 patients (23 females, 21 males) with 54 implants were available for the 1-year follow-up. One implant was lost, thus the 1-year implant survival was 98%. A statistically significant mean marginal bone loss was observed between baseline and 6 months (1.1 mm, range: -0.7 to 4.4 mm; n=49) and between baseline and 12 months (1.6 mm, range: -0.8 to 4.6 mm; n=50). A total of 18% of the implants were characterized by a bone loss of more than 3 mm. No bleeding on probing was observed around 83% of the implants. Plaque was registered at 15% of the implants. The most common complications were related to the provisional crown, i.e. fracture (n=3) and loss of retention (n=3). CONCLUSIONS: A high 1-year implant survival was observed in the present study. However, the excessive peri-implant marginal bone loss around several implants indicates that this implant should be used with caution until further studies have been conducted.

Immediate vs. early loading of dental implants: 3-year results of a randomized controlled clinical trial.

OBJECTIVES: The aim of the present study was to test whether or not immediately loaded implants exhibit the same survival rates as early loaded implants. MATERIAL AND METHODS: Eleven patients with bilateral free end mandibles were randomly assigned to treatment either with immediately (test) or early loaded implants (control). Test implants received provisionals in occlusion on the day of surgery, control implants 6 weeks later. Parameters assessed included implant stability quotient (ISQ), plaque, prosthesis stability and radiographs at baseline (implant insertion), 1 and 3 years. The statistical analysis was performed by means of Student's paired t-test and Wilcoxon's signed-rank test. The level of significance was set at P<0.05. RESULTS: After a mean observation period of 39.8 months (36.7-53.1), three test implants were lost in two patients resulting in a survival rate of 85% compared with 100% for control implants. At baseline, the mean marginal bone level was significantly higher at test implants (mean=0.36 mm, SD +/-0.5) compared with control implants (1.08+/-0.37 mm). For both test and control implants, the bone level significantly decreased from baseline to 3 years (test: 1.51+/-0.79 mm; control: 0.89+/-0.94 mm). The bone loss until 3 years was not significantly different between test and control group. There was no significant difference for ISQ both at test and control implants between baseline (test: 63.59+/-4.62 mm, control: 65.35+/-7.43 mm) and 3 years (test: 66.47+/-7.47 mm, control 68.80+/-8.75 mm). CONCLUSIONS: Immediate loading was associated with a lower implant survival rate. Although the test implants were placed with increased sink depth compared with the control implants, the marginal bone levels were not different between test and control at 3 years.