Immediate loading of implants in the maxilla: survival and bone loss after at least 2 years in function

Purpose: To compare survival and peri-implant bone loss of immediately loaded surface enhanced implants in the maxilla, supporting single crowns, fixed partial dentures and fixed full dentures. Materials and Methods: The study includes all subjects referred for implant treatment in the maxilla followed by immediate loading between November 2004 and 2007 with a minimum follow-up of at least 2 years. Smokers were excluded. Implant survival and bone loss were assessed by an external calibrated examiner (SV) comparing digital peri-apical radiographs taken during recall visits with baseline (day of loading = day after implant placement). An implant was considered successful when bone loss did not exceed 1mm. Survival of implants supporting single crowns (SC), fixed partial dentures (FPD) and fixed full dentures (FFD) were compared using the log-rank test. A linear mixed-effect model analysis was used to evaluate bone loss because of clustering of implants in patients. Results: 306 implants in 55 patients (31 females, 24 males; mean age 57.5, SD 11.4, range 19-77) with a mean follow-up of 35 months (SD 10.2; range 24-58) were included. One implant failed, resulting in an overall survival rate of 99.7% on implant level and 98.2% on patient level. No statistically significant differences (p = 0.734) were observed comparing survival rates for SC's (100 %), FPD's (98 %) and FFD's (100 %)The overall mean bone loss was 0.27 mm (SD 0.37; range 0.00 - 2.55) and independent of the prosthetic reconstruction. Conclusion: Immediate loading in the maxilla is a predictable and reliable treatment option with high survival rates and limited peri-implant bone loss after 2 years when using fluoride-modified implants. No statistically significant differences were found comparing implants supporting single crowns, fixed partial dentures and fixed complete dentures.

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