Skip to main content

Advertisement

SpringerLink
Log in

Immediate versus conventional loading of mandibular implant-retained overdentures: a 3‐year follow‐up of a randomized controlled trial

  • Research
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objectives

There is a scarcity of randomized clinical trials (RCT) that report medium- and long-term results and a lack of consensus in the literature on the predictability of immediately loaded unsplinted narrow diameter implants supporting mandibular overdentures. This RCT compared the performance of conventional (CL) and immediate loading (IL) of mandibular overdentures retained by two narrow-diameter implants for 3 years.

Materials and methods

Patients from an RCT treated with CL or IL were invited to attend to 2- and 3-year follow-ups. Clinical, radiographic, functional, and oral health-related quality of life parameters were evaluated. Prosthetic maintenance events, biological complications, and success and survival rates were also recorded. The data were tested by multilevel mixed-effects linear regression analysis and chi-squared tests.

Results

The 1-year survival rates of 90% in the CL group and 85% in the IL group were maintained as no implants were lost between 1 and 3 years. The marginal bone loss (MBL) in the IL group was significantly lower after year 3 (-0.04; p < 0.01). Significant changes were found only for the intra-group comparisons in the third year of function: (i) CL and IL presented similar progression of implant stability, MBL, and posterior bone area resorption; (ii) while CL started deteriorating of masticatory function, IL still exhibited functional evolution and (iii) oral comfort domain in the CL and pain domain in the IL were improved.

Conclusion

Although IL experienced the lowest MBL after 3 years, the outcomes showed that both loading protocols result in predictable medium-term rehabilitation when monitored annually.

Clinical relevance

It can be expected that in the third year of function, patients with immediate loading may present more complaints related to general performance even with acceptable masticatory function and self-reported improvements in oral comfort.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Data availability

All data generated or analyzed during this study are included in this published article (and its supplementary information files).

References

  1. Emami E, Heydecke G, Rompré PH et al (2009) Impact of implant support for mandibular dentures on satisfaction, oral and general health-related quality of life: a meta-analysis of randomized-controlled trials. Clin Oral Implant Res 20:533–544. https://doi.org/10.1111/j.1600-0501.2008.01693.x

    Article  Google Scholar 

  2. Schuster AJ, Marcello-Machado RM, Bielemann AM et al (2017) Short-term quality of life change perceived by patients after transition to mandibular overdentures. Braz Oral Res 31:1–9. https://doi.org/10.1590/1807-3107bor-2017.vol31.0005

    Article  Google Scholar 

  3. Esposito M, Grusovin MG, Willings M et al (2007) The effectiveness of immediate, early, and conventional loading of dental implants: a Cochrane systematic review of randomized controlled clinical trials. Int J Oral Maxillofac Implants 22:893–904

    PubMed  Google Scholar 

  4. Omura Y, Kanazawa M, Sato D et al (2016) Comparison of patient-reported outcomes between immediately and conventionally loaded mandibular two-implant overdentures: a preliminary study. J Prosthodont Res 60:185–192. https://doi.org/10.1016/j.jpor.2015.12.010

    Article  PubMed  Google Scholar 

  5. de Freitas Borges T, Mendes FA, de Oliveira TRC et al (2011) Mandibular overdentures with immediate loading: satisfaction and quality of life. Int J Prosthodont 24:534–9

    Google Scholar 

  6. Emami E, Cerutti-Kopplin D, Menassa M et al (2016) Does immediate loading affect clinical and patient-centered outcomes of mandibular 2-unsplinted-implant overdenture? A 2-year within-case analysis. J Dent 50:30–36. https://doi.org/10.1016/j.jdent.2016.04.009

    Article  PubMed  Google Scholar 

  7. Zygogiannis K, Wismeijer D, Aartman IH, Osman RB (2016) A systematic review on immediate loading of implants used to support overdentures opposed by conventional prostheses: factors that might influence clinical outcomes. Int J Oral Maxillofac Implants 31:63–72. https://doi.org/10.11607/jomi.4028

    Article  PubMed  Google Scholar 

  8. Helmy MHED, Alqutaibi AY, El-Ella AA, Shawky AF (2018) Effect of implant loading protocols on failure and marginal bone loss with unsplinted two-implant-supported mandibular overdentures: systematic review and meta-analysis. Int J Oral Maxillofac Surg 47:642–650. https://doi.org/10.1016/j.ijom.2017.10.018

    Article  PubMed  Google Scholar 

  9. Cao ZL, Li X, Lin LJ, Chen YH (2020) Immediate or delayed loading protocols for two-implant mandibular overdentures: a systematic review and meta-analysis of randomized controlled trials. J Prosthet Dent 1–7. https://doi.org/10.1016/j.prosdent.2020.09.011

  10. Borges GA, Costa RC, Nagay BE et al (2020) Long-term outcomes of different loading protocols for implant-supported mandibular overdentures: a systematic review and meta-analysis. J Prosthet Dent 1–14. https://doi.org/10.1016/j.prosdent.2020.04.017

  11. Aldhohrah T, Mashrah MA, Wang Y (2021) Effect of 2-implant mandibular overdenture with different attachments and loading protocols on peri-implant health and prosthetic complications: a systematic review and network meta-analysis. J Prosthet Dent 1–13. https://doi.org/10.1016/j.prosdent.2020.12.016

  12. Baskaradoss JK, Geevarghese A, Baig MR (2020) Peri-implant mucosal response to implant-supported overdentures: a systematic review and meta-analysis. Gerodontology 38:27–40. https://doi.org/10.1111/ger.12505

    Article  PubMed  Google Scholar 

  13. Mifsud DP, Cortes ARG, Attard J (2020) Patient-based outcomes with conventional or mini-implants immediately loaded with locator-retained mandibular overdentures: a cohort study. Clin Implant Dent Relat Res 723–729. https://doi.org/10.1111/cid.12955

  14. Gallucci GO, Morton D, Weber H-P (2009) Loading protocols for dental implants in edentulous patients. Int J Oral Maxillofac Implants 24(Suppl):132–146

    PubMed  Google Scholar 

  15. Bielemann AM, Marcello-Machado RM, Schuster AJ, Chagas Júnior OL, Del Bel Cury AA, Faot F (2019) Healing differences in narrow diameter implants submitted to immediate and conventional loading in mandibular overdentures: a randomized clinical trial. J Periodontal Res 54:241–250

    Article  PubMed  Google Scholar 

  16. Schuster AJ, Marcello‐Machado RM, Bielemann AM et al (2020) Immediate vs conventional loading of Facility Equator system in mandibular overdenture wearers: 1‐year RCT with clinical, biological, and functional evaluation. Clin Implant Dent Relat Res cid.12902. https://doi.org/10.1111/cid.12902

  17. Kutkut A, Rezk M, Zephyr D, Dawson D, Frazer R, Al-Sabbagh M (2019) Immediate loading of unsplinted implant retained mandibular overdenture: a randomized controlled clinical study. J Oral Implantol 45(5):378–389. https://doi.org/10.1563/aaid-joi-d-18-00202

    Article  PubMed  Google Scholar 

  18. Moher D, Schulz KF, Altman DG (2003) The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomised trials. Clin Oral Invest 7:2–7. https://doi.org/10.1007/s00784-002-0188-x

    Article  Google Scholar 

  19. Lekholm U, Zarb GA (1985) Patient selection and preparation. In: Branemark PI, Zarb GA, Albrektsson T (eds) Tissue-Integrated prostheses: osseointegration in clinical dentistry. Quintessnce Publ Co, pp 199–209

    Google Scholar 

  20. Al-Nawas B, Brägger U, Meijer HJA et al (2012) A double-blind randomized controlled trial (RCT) of titanium-13zirconium versus titanium grade IV small-diameter bone level implants in edentulous mandibles - results from a 1-year observation period. Clin Implant Dent Relat Res 14:896–904. https://doi.org/10.1111/j.1708-8208.2010.00324.x

    Article  PubMed  Google Scholar 

  21. Quirynen M, Al-Nawas B, Meijer HJA et al (2015) Small-diameter titanium Grade IV and titanium-zirconium implants in edentulous mandibles: three-year results from a double-blind, randomized controlled trial. Clin Oral Implant Res 26:831–840. https://doi.org/10.1111/clr.12367

    Article  Google Scholar 

  22. Elsyad M, Mohamed S, Shawky A (2017) Posterior mandibular ridge resorption associated with different retentive systems for overdentures: a 7-year retrospective preliminary study. Int J Prosthodont 30:260–265. https://doi.org/10.11607/ijp.5114

    Article  PubMed  Google Scholar 

  23. Fontijn-Tekamp FA, Van Der Bilt A, Abbink JH, Bosman F (2004) Swallowing threshold and masticatory performance in dentate adults. Physiol Behav 83:431–436. https://doi.org/10.1016/j.physbeh.2004.08.026

    Article  PubMed  Google Scholar 

  24. Marcello-Machado RM, Faot F, Schuster AJ, Bielemann AM, Chagas Júnior OL, Del Bel Cury AA (2018) One-year clinical outcomes of locking taper Equator attachments retaining mandibular overdentures to narrow diameter implants. Clin Implant Dent Relat Res 20:483–492. https://doi.org/10.1111/cid.12605

    Article  PubMed  Google Scholar 

  25. Marcello-Machado RM, Faot F, Schuster AJ, Bielemann AM, Nascimento GG, Del Bel Cury AA (2018) How fast can treatment with overdentures improve the masticatory function and OHRQoL of atrophic edentulous patients? A 1-year longitudinal clinical study. Clin Oral Implants Res 29:215–226. https://doi.org/10.1111/clr.13101

    Article  PubMed  Google Scholar 

  26. da Rosa Possebon AP, Marcello-Machado RM, Bielemann AM, Schuster AJ, de Rezende Pinto L, Faot F (2018) Masticatory function of conventional complete denture wearers changing to 2-implant retained mandibular overdentures: clinical factor influences after 1 year of function. J Prosthodont Res 62(4):479–484

    Article  Google Scholar 

  27. Girundi FMDS, Marcello-Machado RM, Girundi ALG, Gonçalves TMSV, Del Bel Cury AA, da Silva WJ (2021Oct 28) Performance of complete dentures fabricated with the simplified and the traditional technique: A randomized clinical trial. J Prosthet Dent. S0022–3913(21):00495–9. https://doi.org/10.1016/j.prosdent.2021.08.024

  28. Policastro VB, Cassiano AFB, Silva MDDD, Viotto HEDC, Leite ARP, Marin DOM, Pero AC (2020Oct) Influence of the height of the mandibular ridge on the masticatory function during the functional adaptation with new complete dentures. J Appl Oral Sci. https://doi.org/10.1590/1678-7757-2020-0092

  29. Carletti TM, Pinheiro MA, Gonçalves TMSV, Rodrigues Garcia RCM (2019) Influence of lower complete denture use on masseter muscles and masticatory function: a longitudinal study. J Oral Rehabil 46(2):127–133

    Article  PubMed  Google Scholar 

  30. Al-Omiri MK, Hammad OA, Lynch E et al (2011) Impacts of implant treatment on daily living. Int J Oral Maxillofac Implants 26:877–886

    PubMed  Google Scholar 

  31. Leao A, Sheiham A (1995) Relation between clinical dental status and subjective impacts on daily living. J Dent Res 74:1408–1413. https://doi.org/10.1177/00220345950740071301

    Article  PubMed  Google Scholar 

  32. Renvert S, Persson GR, Pirih FQ, Camargo PM (2018) Peri-implant health, peri-implant mucositis, and peri-implantitis: case definitions and diagnostic considerations. J Periodontol 89:S304–S312. https://doi.org/10.1002/JPER.17-0588

    Article  PubMed  Google Scholar 

  33. Albrektsson T, Zarb G, Worthington P, Eriksson AR (1986) The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants. Summer 1(1):11–25

  34. Stephan G, Vidot F, Noharet R, Mariani P (2007) Implant-retained mandibular overdentures: a comparative pilot study of immediate loading versus delayed loading after two years. J Prosthet Dent 97:. https://doi.org/10.1016/S0022-3913(07)60017-1

  35. Salman A, Thacker S, Rubin S et al (2019) Immediate versus delayed loading of mandibular implant-retained overdentures: a 60-month follow-up of a randomized clinical trial. J Clin Periodontol 46:863–871. https://doi.org/10.1111/jcpe.13153

    Article  PubMed  Google Scholar 

  36. Elsyad MA, Mahanna FF, Elshahat MA, Elshoukouki AH (2016) Locators versus magnetic attachment effect on peri-implant tissue health of immediate loaded two implants retaining a mandibular overdenture: a 1-year randomised trial. J Oral Rehabil 43:297–305. https://doi.org/10.1111/joor.12368

    Article  PubMed  Google Scholar 

  37. Miyamoto I, Tsuboi Y, Wada E et al (2005) Influence of cortical bone thickness and implant length on implant stability at the time of surgery - clinical, prospective, biomechanical, and imaging study. Bone 37:776–780. https://doi.org/10.1016/j.bone.2005.06.019

    Article  PubMed  Google Scholar 

  38. Vercruyssen M, Quirynen M (2010) Long-term, retrospective evaluation (implant and patient-centred outcome) of the two-implant-supported overdenture in the mandible. Part 2: marginal bone loss. Clin Oral Implants Res 21:466–472. https://doi.org/10.1111/j.1600-0501.2009.01902.x

    Article  PubMed  Google Scholar 

  39. Vandamme K, Naert I, Geris L et al (2007) Histodynamics of bone tissue formation around immediately loaded cylindrical implants in the rabbit. Clin Oral Implant Res 18:471–480. https://doi.org/10.1111/j.1600-0501.2007.01339.x

    Article  Google Scholar 

  40. Vandamme K, Naert I, Geris L et al (2006) Influence of controlled immediate loading and implant design on peri-implant bone formation. J Clin Periodontol 34:. https://doi.org/10.1111/j.1600-051X.2006.01014.x

  41. Tallarico M, Ortensi L, Martinolli M et al (2018) Multicenter retrospective analysis of implant overdentures delivered with different design and attachment systems: results between one and 17 years of follow-up. Dent J 6:71. https://doi.org/10.3390/dj6040071

    Article  Google Scholar 

  42. Komagamine Y, Kanazawa M, Sato D, Minakuchi S (2019) A preliminary comparison of masticatory performances between immediately loaded and conventionally loaded mandibular two-implant overdentures with magnetic attachments. Clin Implant Dent Relat Res 21:130–137. https://doi.org/10.1111/cid.12698

    Article  PubMed  Google Scholar 

  43. Iwaki M, Kanazawa M, Sato D et al (2019) Masticatory function of immediately loaded two-implant mandibular overdentures: a 5-year prospective study. Int J Oral Maxillofac Implants 34:1434–1440. https://doi.org/10.11607/jomi.7565

    Article  PubMed  Google Scholar 

  44. Menassa M, de Grandmont P, Audy N et al (2016) Patients’ expectations, satisfaction, and quality of life with immediate loading protocol. Clin Oral Implant Res 27:83–89. https://doi.org/10.1111/clr.12515

    Article  Google Scholar 

  45. Stricker A, Gutwald R, Schmelzeisen R, Gellrich NG (2004) Immediate loading of 2 interforaminal dental implants supporting an overdenture: clinical and radiographic results after 24 months. Int J Oral Maxillofac Implants 19:868–872

    PubMed  Google Scholar 

  46. Büttel AE, Gratwohl DA, Sendi P, Marinello CP (2012) Immediate loading of two unsplinted mandibular implants in edentulous patients with an implant-retained overdenture: an observational study over two years. Schweiz Monatsschr Zahnmed=Rev Mensuelle Suisse d’odonto-Stomatol= Riv Mensile Svizzera odontol Stomatologia 122:392–7

    Google Scholar 

  47. Alfadda SA, Attard NJ, David LA (2009) Five-year clinical results of immediately loaded dental implants using mandibular overdentures. Int J Prosthodont 22:368–373

    PubMed  Google Scholar 

Download references

Acknowledgements

This study was financed in part by the Coordination for the Improvement of Higher Education Personnel—Brazil (CAPES)—Finance code 001.

Author information

Authors and Affiliations

  1. School of Dentistry, Federal University of Pelotas, Gonçalves Chaves Street 457, Pelotas, RS, 96015-560, Brazil

    Alessandra Julie Schuster

  2. Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthodontics, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil

    Otacílio Luiz Chagas-Júnior

  3. Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil

    Anna Paula da Rosa Possebon, Luciana de Rezende Pinto & Fernanda Faot

Authors
  1. Anna Paula da Rosa Possebon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alessandra Julie Schuster
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Otacílio Luiz Chagas-Júnior
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Luciana de Rezende Pinto
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Fernanda Faot
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Anna Paula da Rosa Possebon: Conceptualization, Methodology, Validation, Visualization, Formal analysis, Investigation, Writing—Orginal Draft.

Alessandra Julie Schuster: Methodology, Formal analysis, Investigation, Writing—Review & Editing, Original Draft.

Otacílio Luiz Chagas-Júnior: Investigation, Writing—Review & Editing, Original Draft.

Luciana de Rezende Pinto: Investigation, Writing—Review & Editing, Original Draft.

Fernanda Faot: Conceptualization, Investigation, Writing—Review & Editing, Supervision. Original Draft.

Corresponding author

Correspondence to Fernanda Faot.

Ethics declarations

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The investigation was approved by Research Ethics Committee of the School of Dentistry- UFPel (Report 3.725.829).

Competing interests

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 18 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Possebon, A.d., Schuster, A.J., Chagas-Júnior, O.L. et al. Immediate versus conventional loading of mandibular implant-retained overdentures: a 3‐year follow‐up of a randomized controlled trial. Clin Oral Invest 27, 5935–5946 (2023). https://doi.org/10.1007/s00784-023-05205-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-023-05205-w

Keywords

Search

Navigation