Long‑term results of immediate implantation in mandibular posterior teeth with early loading: A retrospective case series

When immediate molar implants first were proposed, submerged initial healing and delayed loading were the norm. It is now recognized that some early loading of a nonocclusal nature can stimulate faster osseointegration, although full occlusal loading is still delayed for 3 or more months. Here, we test the hypothesis that earlier occlusal loading of mandibular premolar and molar immediate implants may be possible. In this retrospective case series study, 18 mandibular molar and nine mandibular premolar teeth were atraumatically extracted and immediate implants placed 1–2 mm apical to buccal and lingual crestal bone. Periimplant gaps received particular allograft covered with acellular dermal matrix barrier. Healing abutments were placed through puncture points in the membranes to help in stabilizing the latter and to permit nonsubmerged site healing. At 6−8 weeks, each implant was evaluated for stability using the Periotest® device and restored if the Periotest® (PTV) value seen was negative. Data were analyzed by t test and MannWhitney U at a significance level of P < 0.05. Retrospective assessment of all 27 implants after 5 years’ period of follow up showed all implants to have survived. Overall mean crestal bone loss was determined to be−0.25 ± 0.54 mm. Individual mean bone levels for mesial and distal surfaces were−0.24 ± 0.77 mm and−0.26 ± 0.72 mm, respectively (P = 0.78). A statistically significant difference in bone loss between genders was detected. Overall mean probing depth was 2.09 ± 0.57 mm. Based on the widely used Albrektsson criteria, the overall survival and success rate was 100%. Immediate implants placed into mandibular premolar and molar extraction sockets and allowed nonsubmerged healing may be ready for restoration at earlier times than previously thought possible.