Abstract
Data sources
PubMed, Web of Science, Cochrane Oral Health Group Trials Register, ClinicalTrials.gov, CenterWatch.com, ClinicalConnection.com.
Study selection
Randomised and non-randomised studies were included comparing implant failure rates in any group of patients receiving submerged versus immediately loaded non-submerged dental implants. Selection was conducted independently by three reviewers.
Data extraction and synthesis
Titles and abstracts of all reports identified through the electronic searches were read independently by the three authors. Studies were selected based on inclusion and exclusion criteria, with disagreements resolved through discussion. Study quality was assessed using the Cochrane risk of bias tool. Implant failure and post-operative infection were the dichotomous outcome measures evaluated. Weighted mean differences (WMD) were calculated and meta-analysis conducted.
Results
Twenty eight studies, consisting of six randomized clinical trials, 14 controlled clinical trials and eight retrospective analyses were included. 23 studies were considered to be at high risk of bias, one at moderate risk and four at low risk of bias. The relative risk (RR) of failure was higher in immediately loaded implants RR = 1.78 (95% CI; 1.12– 2.83). The number needed to treat (NNT) to prevent one patient having an implant failure is 50 (95% CI; 25–100). Analysis suggests the possibility of publication bias.
Conclusions
The difference between immediately loading and delayed loading of an implant statistically affected the implant failure rate. No statistically significant effects on the occurrence of post-operative infection were observed between the two techniques. Results should be interpreted with caution due to lack of control of confounding factors, the retrospective design of some studies included and the small cohort sizes within the studies.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Albrektsson T, Brånemark PI, Hansson HA, Lindström J . Osseointegrated titanium implants. Requirements for ensuring a long-lasting, direct bone-to-implant anchorage in man. Acta Orthop Scand 1981; 52: 155–170.
Heydenrijk K, Raghoebar GM, Meijer HJ, Van Der Reijden WA, Van Winkelhoff AJ, Stegenga B . Two-part implants inserted in a one-stage or a two-stage procedure. A prospective comparative study. J Clin Periodontol 2002; 29:901–909
Roberts EW, Poon LC, Smith RK . Interface histology of rigid endosseous implants. J Oral Implantol 1986; 12: 406–416.
Gallucci GO, Benic GI, Eckert SE, et al. Consensus statements and clinical recommendations for implant loading protocols. Int J Oral Maxillofac Implants 2014; 29: 287–290.
Chrcanovic BR, Albrektsson T, Wennerberg A . Immediately loaded non-submerged versus delayed loaded submerged dental implants: a meta-analysis. Int J Oral Maxillofac Surg 2015; 44: 493–506. http://dx.doi.org/10.1016/j.ijom.2014.11.011
Moher D, Liberati A, Tetzlaff J . Altman DG ; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 6: e1000097. doi:10.1371/journal.pmed1000097
Aglietta M, Siciliano VI, Rasperini G, Cafiero C, Lang NP, Salvi GE . A 10-year restrospective analysis of marginal bone-level changes around implants in periodontally healthy and periodontally compromised tobacco smokers. Clin Oral Implants Res 2011; 22:47–53.
Chrcanovic BR, Albrektsson T, Wennerberg A . Reasons for failures of oral implants. J Oral Rehabil 2014; 41: 443–476.
Testori T, Meltzer A, Del Fabbro M, et al. Immediate occlusal loading of Osseotite implants in the lower edentulous jaw. A multicenter prospective study. Clin Oral Implants Res 2004; 15:278–284.
Ericsson I, Randow K, Nilner K, Peterson A . Early functional loading of Brånemark dental implants: 5-year clinical follow-up study. Clin Implant Dent Relat Res 2000; 2:70–77.
Moayyedi P . Meta-analysis: Can we mix apples and oranges? Am J Gastroenterol 2004; 99: 2297–2301.
Esposito M, Grusovin MG, Chew YS, Coulthard P, Worthington HV . Interventions for replacing missing teeth: 1- versus 2-stage implant placement. Cochrane Database Syst Rev 2009; 3: Art. No. CD006698. DOI: 10.1002/14651858.CD006698.pub2.
Author information
Authors and Affiliations
Additional information
Address for correspondence: Dr BR Chrcanovic, Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden. E-mail: bruno.chrcanovic@mah.se
Chrcanovic BR, Albrektsson T, Wennerberg A. Immediately loaded non-submerged versus delayed loaded submerged dental implants: a meta-analysis. Int J Oral Maxillofac Surg 2015; 44: 493–506.
Rights and permissions
About this article
Cite this article
McReynolds, D., Duane, B. Review finds failure rates lower for delayed loaded submerged dental implants. Evid Based Dent 16, 112–113 (2015). https://doi.org/10.1038/sj.ebd.6401134
Published:
Issue date:
DOI: https://doi.org/10.1038/sj.ebd.6401134
