Int J Oral Maxillofac Implants. 2014;29 Suppl:256-70. doi: 10.11607/jomi.2014suppl.g4.3.
To report on the effect of immediate implant loading with fixed prostheses compared to early and conventional loading on implant and prosthesis survival, failure, and complications.
An electronic and manual search was conducted to identify randomized controlled clinical trials (RCTs) as well as prospective and retrospective studies involving rough surface implants and implant fixed complete dental prostheses for edentulous patients.
The 62 studies that fulfilled the inclusion criteria featured 4 RCTs, 2 prospective case-control studies, 34 prospective cohort studies, and 22 retrospective cohort studies. These studies yielded data from 2,695 patients (2,757 edentulous arches) with 13,653 implants. Studies were grouped according to the loading protocol applied; 45 studies reported on immediate loading, 8 on early loading, and 11 on conventional loading. For the immediate loading protocol with flap surgery, the implant and prosthesis survival rates ranged from 90.1% to 100% and 93.75% to 100%, respectively (range of follow-up, 1 to 10 years). When immediate loading was combined with guided flapless implant placement, the implant survival rates ranged from 90% to 99.4%. For the early loading protocol, the implant and prosthesis survival rates ranged from 94.74% to 100% and 93.75% to 100%, respectively (range of follow-up, 1 to 10 years). For the conventional loading protocol, the implant and prosthesis survival rates ranged from 94.95% to 100% and 87.5% to 100%, respectively (range of follow-up, 2 to 15 years). No difference was identified between maxilla and mandible.
When selecting cases carefully and using dental implants with a rough surface, immediate loading with fixed prostheses in edentulous patients results in similar implant and prosthesis survival and failure rates as early and conventional loading. For immediate loading, most of the studies recommended a minimal insertion torque of 30 Ncm. The estimated 1-year implant survival was above 99% with all three loading protocols. Caution is necessary when interpreting these results, as there are many confounding factors that affect treatment outcomes with each of the loading protocols.
报告即刻负载固定义齿与早期负载和常规负载对种植体和修复体存活率、失败率和并发症的影响。
通过电子和手动检索，确定了涉及粗糙表面种植体和无牙患者种植体固定全口义齿的随机对照临床试验（RCT）以及前瞻性和回顾性研究。
符合纳入标准的 62 项研究包括 4 项 RCT、2 项前瞻性病例对照研究、34 项前瞻性队列研究和 22 项回顾性队列研究。这些研究共纳入 2695 名患者（2757 个无牙弓）和 13653 个种植体的数据。研究根据应用的负载方案进行分组；45 项研究报告了即刻负载，8 项研究报告了早期负载，11 项研究报告了常规负载。对于有瓣手术的即刻负载方案，种植体和修复体的存活率分别为 90.1%至 100%和 93.75%至 100%（随访时间范围为 1 至 10 年）。当即刻负载与引导无瓣种植体放置相结合时，种植体的存活率范围为 90%至 99.4%。对于早期负载方案，种植体和修复体的存活率分别为 94.74%至 100%和 93.75%至 100%（随访时间范围为 1 至 10 年）。对于常规负载方案，种植体和修复体的存活率分别为 94.95%至 100%和 87.5%至 100%（随访时间范围为 2 至 15 年）。上颌和下颌之间没有差异。
在仔细选择病例并使用粗糙表面种植体的情况下，无牙患者即刻负载固定义齿的种植体和修复体存活率和失败率与早期和常规负载相似。对于即刻负载，大多数研究建议最小插入扭矩为 30 Ncm。三种负载方案的 1 年种植体存活率均高于 99%。在解释这些结果时需要谨慎，因为每种负载方案都有许多混杂因素会影响治疗结果。
