Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Rio Grande do Sul, Brazil.
Department of Prosthodontics and Periodontology, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil.
Clin Implant Dent Relat Res. 2020 Jun;22(3):270-280. doi: 10.1111/cid.12902. Epub 2020 May 4.
The use of immediate loading (IML) is still poorly explored in elderly patients and implant-retained mandibular overdenture (IMO) wearers. For this reason, more comparisons to conventional loading (CL) are required.
To evaluate the clinical, biological, functional, and oral health-related quality of life (OHRQOL) influence of CL and IML loading on elders wearing IMO retained by the Facility-Equator system up to 1 year after implant installation.
Twenty edentulous patients received two narrow diameter implants in the mandible; the loading type (CL or IML) was randomized. The clinical parameters were monitored along with prosthetic events, marginal bone loss (MBL) and bone level change (BLC), implant stability quotients (ISQ), masticatory performance outcomes, and Interleukin 1 beta (IL-1β) and tumor necrosis factor alpha (TNF-α) levels in the peri-implant crevicular fluid during the first year of loading. The OHRQoL was assessed via the Oral Health Impact Profile-EDENT questionnaire. Data were analyzed by the Mann-Whitney, χ , Wilcoxon paired, and McNemar tests.
After 1 year, MBL, BLC and ISQ were statistically identical (P > .05) in the CL and IML groups. The probing depth at 12 months in the CL group (2.19 mm) was higher than in the IML group (1.29 mm; P ≤ .0001). TNF-α was 33.6% higher in the CL group at 6 months (P = .043), while IL-1β was significantly higher in the IML group up to 6 months. The survival rate was 90% in the CL group and 85% in the IML group; 33 prosthetic events occurred in CL group and 23 in IML group.
After 12 months, both loading protocols are viable and result in similar clinical, biological, functional, and OHRQOL outcomes. However, IML generates better adaptation of the peri-implant tissues, faster improvement in OHRQoL and fewer prosthetic intercurrences than CL.
即刻负载（IML）在老年患者和种植体支持的下颌覆盖义齿（IMO）佩戴者中的应用仍未得到充分探索。出于这个原因，需要更多地与传统负载（CL）进行比较。
评估在种植体植入后 1 年内，使用 Facility-Equator 系统保留 IMO 的老年人，采用 CL 和 IML 负载对临床、生物学、功能和口腔健康相关生活质量（OHRQOL）的影响。
20 名无牙颌患者下颌植入两根窄径种植体，随机分为 CL 或 IML 加载组。在加载的第一年，监测临床参数、修复体事件、边缘骨丧失（MBL）和骨水平变化（BLC）、种植体稳定性指数（ISQ）、咀嚼性能结果以及种植体周围龈沟液中的白细胞介素 1β（IL-1β）和肿瘤坏死因子-α（TNF-α）水平。使用口腔健康影响简表-EDENT 问卷评估 OHRQoL。采用 Mann-Whitney、χ²、Wilcoxon 配对和 McNemar 检验对数据进行分析。
1 年后，CL 和 IML 组的 MBL、BLC 和 ISQ 差异均无统计学意义（P>.05）。CL 组 12 个月时的探诊深度（2.19mm）高于 IML 组（1.29mm；P≤.0001）。CL 组 6 个月时 TNF-α 升高 33.6%（P=.043），而 IML 组 6 个月时 IL-1β 显著升高。CL 组的生存率为 90%，IML 组为 85%；CL 组发生 33 次修复体事件，IML 组发生 23 次。
12 个月后，两种负载方案均可行，且具有相似的临床、生物学、功能和 OHRQOL 结果。然而，与 CL 相比，IML 可更好地适应种植体周围组织，更快地改善 OHRQoL，并减少修复体并发症。
