Department of Prosthodontics, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt.
Implant Dent. 2011 Apr;20(2):157-66. doi: 10.1097/ID.0b013e31820fbd09.
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.
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.
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.
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.
本研究旨在评估两种不同即刻负载方案（即刻功能性负载和渐进性负载）对双侧下颌后牙区植入物支持结构的影响。
5 名下颌无牙颌 Kennedy 第一类患者共植入 30 枚种植体，每个患者下颌前磨牙/磨牙区每侧植入 3 枚种植体。一侧采用即刻功能性负载方案即刻负载，另一侧采用即刻渐进性负载方案负载。种植术后 0、4、9、24 个月采用牙科 CT 进行影像学评估。
统计分析显示，即刻渐进性负载组在种植体边缘骨高度（P = 0.011）和种植体边缘骨密度（P = 0.009）方面的骨反应更为有利，差异具有统计学意义。
即刻渐进性负载方案可获得更可预测的种植体边缘骨反应，并确保更好的种植体预后，优于即刻功能性负载方案；这一结果支持逐渐负载或刺激可使骨在 2 年的种植体随访期内成熟并更致密的观点。
