Immediate Loading versus traditional approach in functional implantology

Immediate loading in implantology brings various benefits to the patient both esthetical and functional. The aim of this study was to evaluate the efficiency of the Nobel Replace® implant while applying a functionalization implant protocol with fixed prostheses immediately loaded after their placement and to compare the results of this technique with the traditional loading. The study sample consisted of 202 subjects who had 198 delayed-loaded dental implants and 187 immediate-loaded implants. A total of n.385 implants were placed in the study sample. The primary stability was evaluated through the measurement of the insertion torque values. The torque value at 35 N was considered the key factor while choosing whether or not to perform an immediate load procedure. A resonance frequency analysis (RFA) was used for measuring implant stability quotient (ISQ).Throughout the first year 10 implants failed, thus the cumulative success rate of all the implants was 97.04%. Six of the failed implants (3%) were of the immediate load type (placed 1 in the antero-superior, 3 in the postero-superior, and 2 in the postero-inferior area) while the remaining 4 (2.1%) were of the non-immediate load type. The 2-year prosthetic survival rate was equal to 100%. Three of the six immediate load implants that had failed had a torque value slightly above the crucial value (35 N) at the moment of the implantation. Amongst the implants that survived the first year there was no significant statistic difference between the immediate-loaded implants (ISQ 60.95±0.26) and the traditional delayed-loaded implants (ISQ 61.01±0.29). As well as no significant statistical difference was registered in the rate of the marginal bone reabsorption between the immediate-loaded implants (0.46±0.20 mm/1 year) and the traditional delayed-loaded implants (0.50±0.23mm/1year). No implants placed using bone grafting technique failed. These results suggest that the immediate loading protocol implant is to be considered a predictable and safe treatment choice, as long as the implant presents an appropriate primary stability and are strongly stabilized together