Clinical Outcomes of Immediately Loaded Implant-Supported Mandibular Fixed Prostheses

Objectives: To test the null hypothesis that a procedure whereupon dental implants in the edentulous mandible are immediately loaded with a denture has no benefits compared to a traditional loading procedure in terms of implant survival, clinical function, short-term prognosis and patient quality of life. Methods: A parallel randomized controlled trial with 2 study arms was approved by the University of Toronto ethical committee and initiated in 2006. Forty participants are being recruited amongst patients seeking implant-supported prosthetics treatment at the Implant Prosthodontic Unit (IPU), University of Toronto. Four TiUnite dental implants (NobelBiocare®, Gothenburg, Sweden) are placed following the standard surgical protocol that has been used for more than two decades at IPU. Immediately after surgery, the allocation code, provided by a third independent part that conducted the randomization, was opened to determine which arm the patient should enter. In the experimental group, the denture was modified into a fixed bridge on the same day of the surgery. The permanent FPD was fabricated 2 weeks later. In the control group, the implants remained submerged for 3 months. The clinical evaluations were done by an independent blinded investigator. Further outcomes will be measures of quality of life and patient mediated cost effectiveness analysis of treatment. Results: Early clinical results show minor difference in prevalence of osseointegration and patient satisfaction between the two groups. Implant survival is slightly higher in the control group. However, the immediate loading group reported better quality of life. Both groups reported more satisfaction with implant treatment compared to conventional complete dentures. Conclusion: Implant survival, clinical function, short-term prognosis and quality of life profile of the fixed prostheses in the mandibles are comparable in patients treated with immediate loading or conventional loading techniques. Acknowledgment: This study has been funded by NobelBiocare®, Gothenburg, Sweden.