Clinical and radiographic evaluation of immediate versus delayed loading of dental implants at anterior maxilla: a randomized controlled trial.

چکیده اصلی

BACKGROUND: Immediate loading significantly improves oral health related quality of life (OHRQoL) as well as satisfaction of patients. Future trials will determine the role of immediate loading protocol in clinical scenarios with various amounts of available jaw bone using different numbers of implants to retain a fixed prosthetic restoration in partially edentulous maxilla. The aim of this study is to evaluate and compare the clinical stability and radiographic difference of osteointegration between immediate and delayed loaded dental implants in the anterior and premolar regions of the maxilla. METHODS: Sixteen patients aged from 20 to 55 were divided into two equal groups. Group 1 consisted of 8 implants that were placed and loaded 6 months after placement, while group 2 consisted of 8 implants that were placed and immediately loaded with a provisional PMMA restoration; after 6 months, the provisional restoration was replaced by a fixed restoration. Each implant was clinically evaluated for implant stability using the Osstell device and radiographically evaluated for bone density around the implant using postoperative indirect standardized digital radiographs taken immediately after implant placement and after 3 and 6 months. RESULTS: Both groups had a significant decrease in pain and swelling after surgery over time, but the immediate loading group had consistently lower values on day 1 (p = 0.001), day 3 (p = 0.023), and day 7 (p < 0.001). Moreover, the immediate loading group also had a significantly lower edema at all-time points (day 1: p = 0.005; day 3 and day 7: p < 0.001). Implant stability (ISQ) increased over time in both groups, while no statistically significant between-group difference was observed at baseline or at 6 months. Peri-implant bone density showed no significant differences between groups at any time point. CONCLUSIONS: Immediate implant loading was found to be a better alternative than delayed loading, as it provides comparable bone density and implant stability while significantly reducing postoperative pain and edema, consequently enhancing quality of life, aesthetic results, and early patient comfort without compromising radiographic performance. TRIAL REGISTRATION: NCT07381283 (registration date: February 2, 2026).

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