Three Year Outcomes of Early Loaded Implants in Posterior Maxilla
219
(1); James Mellonig DDS, MS(2)
(2); Wilfried Wagner MD, Ph.D.(3)
(3)
Clark Stanford DDS Ph.D.(1)
(1)
(1) University
University of
of Iowa,
Iowa, Iowa
Iowa City,
City, IA
IA USA;
USA; (2)
(2) University
University of
of Texas
Texas San
San Antonio,
Antonio, San
San Antonio,
Antonio, Texas,
Texas, USA;
USA; (3)
(3) Universitetsklinik
Universitetsklinik Mainz,
Mainz, Frankfurt,
Frankfurt, Germany
Germany
Topic: Implant therapy outcomes, prosthetic aspects
Abstract
Abstract
Results
Results
Aim: The purpose of this study is to investigate effects of early loading of the
OsseoSpeed™ dental implant (Astra Tech AB) on implant stability, marginal bone
loss and survival. Three year results are reported. Methods: 47 patients with
edentulous posterior maxilla were treated with a total of 131 implants, at three
centers. Two to three self-tapping implants were placed with a one-stage surgical
approach. Resonance Frequency Analysis (RFA) and radiological assessment
were made. RFA values were recorded 7 times over the first year of loading.
After 6 weeks of healing, provisional restorations were fabricated and functional
load applied. Results: 80 implants in 32 subjects were loaded within 56 days of
placement while 43 implants in 14 subjects had a healing period greater than 56
days at the clinical discretion of the investigators due to reported lack of implant
stability over first 6 weeks post-op. Remaining implants were lost to follow-up
(n=2) or failed to osseointegrate prior to load (n=6). In the early load group, 41%
of the patients were male and 59% female. Mean age was 59 ± 11 years and
62% were non-smokers and 38% ex-smokers. Smokers were excluded from the
study. In the early load group, 56% were placed with Osteotome technique and
98% had primary fixation at placement with 85% placed in type 3 and 4 bone.
Installed implant positions were: 1st premolar 20%, 2nd premolar 43%, 1st molar
30%, and 2nd molar 8%. Initial RFA measurements had a median value of 66 ± 7
ISQ at placement in the early load group and a final median of 70 ± 7 ISQ at 60
weeks. Mean marginal bone loss in the early load group over three years from
implant placement was 0.37 mm ± 0.74 (range -2.70 loss to 1.55 mm gain).
Cumulative Implant Survival Rate (CISR) for all implants at risk was 92% (n=10
losses of 131 at risk), 96% for the early load group (3 of 80 at risk) and 98% (1 of
43 at risk) for the delayed loading group.
Conclusions: Three year results in posterior edentulous maxillas indicate
satisfactory results with early loading of implants when implants have initial
primary stability obtained by drilling or Osteotome indirect sinus lifting.
Background
Background and
and Aim
Aim
Aim: The purpose of this study is to investigate effects of early loading of
the OsseoSpeed™ dental implant (Astra Tech AB) on implant stability,
marginal bone loss, and survival. Three year results are reported.
Methods
Methods and
and Materials
Materials
A total of 47 patients with edentulous posterior maxilla (Kennedy Class I
or II) were treated with a total of 131 implants, at three centers. Two to
three self-tapping implants were placed in a transmucosal position.
Resonance Frequency Analysis (RFA) and radiological assessment
were made. RFA values were recorded at 2 & 6 weeks following implant
placement and then five times over the first year. After 6 weeks of
healing, provisional restorations were fabricated and functional load
applied. 80 implants in 32 subjects were loaded within 56 days of
placement while 43 implants in 14 subjects had a healing period greater
than 56 days at the clinical discretion of the investigators due to reported
lack of implant stability over first 6 weeks post-op. Remaining implants
were lost to follow-up (2) or failed to osseointegrate prior to load (6).
Conclusions
Conclusions
Three year results in posterior edentulous maxillas indicate satisfactory
results with early loading of implants when implants have initial primary
stability obtained by drilling or Osteotome indirect sinus lifting.
Study design allowed for an early loading group to be treated per
protocol and a “delayed” or conventional loading protocol to be applied
when implants were not stable at placement.
Study supported by Astra Tech AB, Mölndal, Sweden.
Presented
Presented at
at the
the 19th
19th Annual
Annual Scientific
Scientific Meeting
Meeting of
of the
the European
European Association
Association of
of Osseointegration
Osseointegration –– 6-9
6-9 October
October 2010,
2010, Glasgow
Glasgow