No difference between failure rates of early and conventionally loaded implants.

DATA SOURCES: The Cochrane Oral Health Group's Trials Register, Cochrane Central Register of Controlled Trials, Medline and Embase were searched. Handsearching included several dental journals. Authors of all identified trials, an internet discussion group and 55 dental implant manufacturers were contacted to find unpublished randomised controlled trials (RCT).

STUDY SELECTION: RCT were selected of root-form osseo-integrated oral implants that had a followup of 6 months-1 year and which compared the same osseo-integrated root-form implants immediately (within 1 week), early (1 week-2 months) and conventionally loaded (after 2 months), giving the following outcome measures: failures, implant failures and marginal bone levels on intra-oral radiographs.

DATA EXTRACTION AND SYNTHESIS: Data were independently extracted, in duplicate, by two review authors. Authors were contacted for details of randomisation and withdrawals and a quality assessment was carried out. The Cochrane Oral Health Group's statistical guidelines were followed.

RESULTS: Twenty RCT were identified and 11 trials comprising a total of 300 patients were included. Six trials compared immediate versus conventional loading, three early versus conventional loading and two immediate versus early loading. On a patient, rather than per implant basis, there were no statistically significant differences for any of the meta-analyses.

CONCLUSIONS: It is possible to successfully load dental implants immediately or early after their placement in selected patients, but not all clinicians achieve optimal results when loading the implant immediately. A high degree of primary implant stability (high value of insertion torque) seems to be one of the prerequisites for a successful immediate/ early loading procedure. More well-designed RCT are needed. Priority should be given to trials comparing immediately versus early loaded implants to improve patient satisfaction and decrease treatment time and trials should be reported according to the CONSORT guidelines (https://www.consort-statement.org/).