ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Immediate vs. Early vs. Conventional Implants
Clinical Question In an adult patient with a posterior implant, what is the longevity of immediate versus conventional loading of single implant crowns?
Clinical Bottom Line A significantly higher risk of implant failure is associated with immediate loading of single implant crowns. When compared to conventional loading, immediate nonocclusal loading is associated with a worse outcome. It is possible to successfully load dental implants immediately or early after placement in selected patients, although not all clinicians may achieve optimal results. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 19639076Gonzalo/2009Five studies with 248 implants were analyzed.A Systematic Review and Meta-Analysis of studies
Key resultsImmediate loading of single implant crowns was associated with a significantly higher risk of implant failure. Pooling of randomized controlled trials showed similar results, although the difference was not statistically significant. Immediate nonocclusal loading was also associated with worse outcomes when compared to conventional loading.
#2) 18271370Esposito/200720 RCTs identified; 11 trials including 300 pts.Cochrane Systematic Review of RCTs
Key resultsIt is possible to successfully load dental implants immediately or early after their placement in selected patients, although not all clinicians may achieve optimal results. A high degree of primary implant stability (high value of insertion torque) seems to be 1 of the prerequisites for a successful immediate/early loading procedure. More well-designed RCTs are needed.
Evidence Search PubMED: Immediate Implant or Early Implant
Comments on
The Evidence
Strong evidence recommending conventional loading versus immediate or early loading of single implant crowns. But more RCTs are needed with priority given to trials comparing immediately versus early loaded implants.
Applicability These articles are very applicable for the dentists and the patients. Many patients find temporary prosthesis rather uncomfortable and it would be a great service if the implants can be loaded early without jeopardizing implant success.
Specialty/Discipline (General Dentistry) (Oral Surgery) (Periodontics) (Restorative Dentistry)
Keywords Prosthodontic Dentistry; Immediate implants, early implants
ID# 269
Date of submission: 11/11/2009spacer
E-mail doanv@livemail.uthscsa.edu
Author Vinh D. Doan, DDS, MS
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Thomas Oates, DMD, PhD
Faculty mentor/Co-author e-mail OATES@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Zade Faraj (San Antonio, TX) on 04/12/2012
A search on this topic was completed on the PubMed database in April 2012. The information presented is up to date, accurate, and is the highest level of evidence found.
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