Selection criteria for immediate implant placement and immediate loading for single tooth replacement in the maxillary esthetic zone: A systematic review and meta-analysis

Immediate loading of definitive restorations in partially edentulous patients requiring an implant-supported prosthesis: A scoping review

STATEMENT OF PROBLEM

Interest is growing in immediately loading definitive implant-supported prostheses. However, it appears that implant protocols are evolving faster than their scientific validation.

PURPOSE

The purpose of this scoping review was to identify the current trends, feasibility, and clinical outcomes of a specific clinical loading scenario (type A), where a single definitive implant-retained restoration is delivered within 3 days. The focus question was "In partially edentulous patients requiring an implant-retained prosthesis (population), is immediate loading with a definitive restoration (concept) a viable treatment option (context)?"

MATERIAL AND METHODS

An electronic search was conducted in the PubMed, CENTRAL, Scopus, Embase, and Web of Science databases. Two authors independently reviewed the studies, screened titles and abstracts, and performed full-text analysis. Cross-reference checks within the bibliography of included studies, relevant reviews, and guideline were conducted. Bibliometric information and study details were extracted.

RESULTS

The search identified 2568 titles after removing duplicates. Four studies involving 91 participant and 100 implant-retained restorations were included in this scoping review. The selected articles were a randomized controlled trial (RCT), a prospective clinical study, and the remaining 2 were case series. The follow-up periods investigated ranged from 6 to 26 months. All studies evaluated marginal bone loss as a primary outcome, and only 1 implant failure was reported. Patient-reported outcome measures were favorable, and no major biological or technical complications were reported in any study.

CONCLUSIONS

Immediate loading with a definitive restoration within 3 days appears to be a suitable approach in specific clinical situations.

Group 5 ITI Consensus Report: Implant placement and loading protocols

OBJECTIVES

Working Group 5 was convened to discuss and find consensus on the topics of implant placement and loading protocols associated with single missing teeth in the anterior maxilla (aesthetic zone). Consensus statements, clinical recommendations, patient perspectives and future research suggestions were developed and presented to the plenary for discussion and approval.

MATERIALS AND METHODS

Two systematic reviews were developed and submitted prior to the conference. The group considered in detail the systematic reviews and developed statements, clinical recommendations, patient perspectives and future research suggestions based on the findings of the reviews and experience of group members. Definitive versions were developed after presentation to and discussion by the plenary.

RESULTS

Five consensus statements were developed and approved from each systematic review. Twelve clinical recommendations were developed by the group based on both reviews and experience. Three patient perspectives were developed, and five suggestions made for future research.

CONCLUSIONS

Based on the findings of the systematic reviews and experience of group members, the Type 1A protocol (immediate placement and immediate loading), when utilized in the anterior maxilla under favorable conditions, is considered predictable and is associated with high survival rates. The procedure is considered clinically viable and is associated with aesthetic outcomes, although surgical, technical, and biological complications can occur.