Long‐Term Evaluation of Immediately Loaded Implants in the Edentulous Mandible Using Fixed Bridges and Platform Shifting

Background The immediate loading concept has been extensively documented in the anterior part of the mandible when six primary stable implants are placed, splinted with a fixed prosthesis. Purpose The aim of this study was to evaluate the long-term success of immediately occlusal loaded implants with a progressive thread design and platform shifting in the edentulous mandible. Materials and Methods Seventy-eight implants placed in 13 patients and were connected with their abutments immediately after surgery. The implants were splinted using a fixed temporary restoration having occlusal contacts in the centric and group function in the lateral movements of the mandible (immediate occlusal loading). The patients were advised to use soft/liquid diet for the first 6 to 8 weeks of healing in order to reduce excessive loading in the bone-to-implant interface. Abutment level impressions were taken without removing the abutments in order to fabricate the final prostheses. The final restorations were delivered 4 to 8 weeks after surgery and cemented temporarily in order to evaluate the peri-implant soft tissue condition at the different time intervals after removal of the restoration. Clinical stability and radiological indices were evaluated at the start of loading, at 3-month interval after loading, and then annually. Results After a mean loading period of 75.29 (± 38.18) months, no implant was lost (100% success rate). All clinical indices had values in normal levels. The Periotest values demonstrated a continuous reduction, representing high stability. The crestal bone level was relatively stable and only minimal crestal bone loss was observed in some implants. Conclusions Long-term success and stability of the peri-implant tissues around immediately loaded mandibular implants are expected when implants with platform shifting are restored with bridges without abutment removal.