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The Effect of Two Different Immediate Loading Protocols in Implant-Supported Screw-Retained Prostheses

Khorshid, Heba E. BDS, MS*; Hamed, Hamdy Aboul Fotouh BDS, MS, PhD; Aziz, Essam A. BDS, MS, PhD

doi: 10.1097/ID.0b013e31820fbd09
Basic and Clinical Research
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Background: The aim of this work was to evaluate the changes that occur in the supporting structures of implants placed bilaterally in the posterior mandibular region as a result of 2 different immediate loading protocols: the immediate functional loading protocol and the immediate progressive loading protocol.

Materials and Methods: Thirty implants were placed in 5 patients with unmodified mandibular Kennedy Class I. For each patient, 3 implants were placed on each side of the patient's dental arch at the premolar/molar mandibular region. At one side, the implants were immediately loaded following an immediate functional loading protocol, whereas the other side was loaded following an immediate progressive loading protocol. Radiographic evaluation was carried out using dental computed tomography at intervals of 0, 4, 9, and 24 months after implant surgery.

Results: Statistical analysis showed a more favorable bone reaction with a statistically significant difference in the crestal bone height (P = 0.011) and in the crestal periimplant bone density (P = 0.009) in the immediate progressive loading group than the immediate functional loading group.

Conclusion: The immediate progressive loading protocol yields a more predictable bone reaction in the periimplant crestal bone and ensures better implant prognosis than the immediate functional loading protocol; supporting the idea that gradual loading or stimulation will allow bone to mature and grow denser in a 2-year implant follow-up period.

*Assistant Lecturer, Department of Prosthodontics, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt.

†Professor, Department of Prosthodontics, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt.

‡Assistant Professor, Department of Prosthodontics, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt.

Reprint requests and correspondence to: Heba Ezzeldin A. Khorshid, BDS, MS, 9 Addey Street, Messaha Square, Dokki, Giza, Egypt 12311, E-mail:hebakhorshid@hotmail.com

© 2011 Lippincott Williams & Wilkins, Inc.