Early loading of maxillary fixed cross-arch dental prostheses supported by six or eight oxidized titanium implants: results after 1 year of loading, case series.

BACKGROUND: Recent reports have demonstrated that immediate/early loading of dental implants is a clinically feasible concept with results similar to those for two-stage procedures, at least in good bone qualities. However, documentation of the outcome of immediate/early loading in the totally edentulous maxilla is scarce.

PURPOSE: The present investigation was undertaken to evaluate the outcome over 1 year of oxidized titanium implants when loaded with a fixed full-arch bridge in the maxilla 1 to 9 days after implant placement.

MATERIALS AND METHODS: Ten patients with totally edentulous maxillas were treated with 61 oxidized titanium implants, and a provisional fixed bridge was delivered after 1 to 9 days (mean 2.5 d). Nine patients had six implants and one patient had eight implants supporting the bridge. The provisional bridge was replaced with a permanent bridge after 2 to 7 months (mean 4.1 mo) of loading. Resonance frequency analysis (RFA) for implant stability measurements was made at implant placement in eight patients and in conjunction with permanent bridge connection in five patients. The patients were followed up for 1 year with clinical and radiographic examinations.

RESULTS: Four implants (6.6%) were lost in one patient after 10 weeks of loading owing to an infection. All other implants were clinically stable with a mean marginal bone loss of 1.3 +/- 0.6 mm after 1 year of loading. RFA showed a mean primary stability of 60.1 +/- 3.6 ISQ (implant stability quotient), which increased to 62.8 +/- 1.6 ISQ after, on average, 4 months.

CONCLUSIONS: The results from this limited study on 10 cases indicate that early loading protocols can be applied for cross-arch dental bridges supported by six to eight implants in the maxilla. However, more clinical trials are needed to establish the long-term predictability of the treatment.