7-year follow-up of 93 immediately loaded titanium dental implants.

Recently, several experimental and clinical investigations found that immediately loaded implants obtained satisfactory levels of osseointegration with high success percentages. Only a few long-term studies of immediately loaded implants have been reported in the literature. The aim of this study was a 7-year clinical and radiographic follow-up of 93 immediately loaded dental implants in human patients. Eleven patients were consecutively enrolled in this study. A total of 7 full and 9 partial edentulous arches were rehabilitated. Patients presented a completely edentulous mandible (n=6), a completely edentulous maxilla (n=1), mandibular posterior edentulous areas (n=5), or a posterior maxillary edentulous area (n=1). Patients were rehabilitated with a bar and an overdenture (n=4), a provisional prosthesis of 3 to 12 elements (n=11), or a metal-ceramic bridge of 10 elements (n=1). A total of 93 implants were inserted and loaded within a 24-hour time frame. Six implants failed in the first year after loading. No more failures were observed in the following 6 years, and all the other implants were well integrated from a clinical and radiographic point of view. The cumulative success rate at 7 years was 93.5%, and the prostheses survival rate was 98.5%. The mean marginal bone loss was 0.6 mm after the first year and 1.1 mm at the 7-year evaluation. Primary stability is one of the most important parameters in immediately loaded implants because it avoids micromotion at the bone-implant interface. Four of the 6 failures in our patients occurred in partially edentulous patients; an excessive load applied to these small bridges could be the reason for the failure. Also, the bone quality is important, for 3 of our failed implants had been inserted in D3 bone. Our clinical and radiographic results have shown that these immediately loaded implants have remained osseointegrated for a long period. Our results point to the possibility of using the immediate loading technique in selected and well-informed cases.