https://pubmed.ncbi.nlm.nih.gov/36293738/
Velasco-Ortega E, Cracel-Lopes JL, Matos-Garrido N, Jiménez-Guerra A, Ortiz-Garcia I, Moreno-Muñoz J, Núñez-Márquez E, Rondón-Romero JL, López-López J, Monsalve-Guil L. Int J Environ Res Public Health. 2022 Oct 13;19(20):13162.

Original title: Immediate Functional Loading with Full-Arch Fixed Implant-Retained Rehabilitation in Periodontal Patients: Clinical Study.

BACKGROUND AND GOAL

Fixed implant-supported restorations can be a treatment option to restore dentition in fully edentulous patients with a background of periodontitis. Immediate functional loading of the implants can reduce time, surgical interventions and can improve aesthetic and occlusal function. However, periodontally compromised patients may carry a higher risk for implant failure. It was therefore the goal of the study to assess the feasibility of immediate functional loading of fixed implant-retained restorations in patients with a history of periodontal disease.

METHODS

27 periodontally compromised patients with partial or complete edentulism were treated with dental implants to provide implant-supported prostheses.

Remaining teeth were removed, and implants were placed immediately. In case of complete edentulism implants were placed in healed sites. Peri-implant bone was augmented using cerabone^® and a collagen membrane (Bio-Gide^®).

Prosthetic abutments were connected, and functional loading was completed when the insertion torque achieved at least 35 Ncm. Implant-supported fixed prostheses (screw hybrid fixed or cemented fixed) were placed immediately after the surgeries.

Implant survival and marginal bone loss using computerized tomography were followed for a mean period of 3.5 years.

MAIN RESULTS

• Altogether 305 implants were inserted, which supported 54 fixed prostheses
• No implant was lost, i.e. cumulative implant survival rate of 100%
• 31 implants (10.2%) in 10 patients (37%) were associated with peri-implantitis during the follow-up period
• 51 ± 1.16 mm mean marginal bone loss during the follow-up period
• Patients with chronic medical condition showed higher frequency of peri-implantitis and more marginal bone loss (p = 0.0438 and 0.0486 respectively)
• No differences in any of the analyzed data with respect to prostheses design

CONCLUSIONS

Immediate functional loading of implants placed in edentulous jaws or fresh extraction sites can be considered a valid treatment option for restoring dentition in patients with periodontal disease.

The approach reduces the treatment time as compared to conventional loading protocols.

Concomitant peri-implant Guided Bone Regeneration supported implant osteointegration and contributed to stable marginal bone thanks to the osteoconductive properties and volume stability of cerabone^®.