Immediate Implants with Immediate Loading vs. Conventional Loading: 1-Year Randomized Clinical Trial

Purpose: This 1-year randomized clinical trial compared the bone regeneration and success rates between immediate and conventional loading of dental implants placed immediately after extraction in patients with a past history of periodontal disease. Methods: Sixty patients who chose an immediate implant treatment option to replace a hopeless tooth were included in this study. Patients: Patients were randomly assigned to receive immediate implants with either immediate loading (group A) or conventional loading after 3 months (group B). At baseline, both groups received a mucoperiosteal flap, extraction, implant placement, allograft bone, and a membrane. Group A received a provisional crown. In group B, a cover screw was placed and primary closure was achieved. The patients were evaluated at 3, 6, and 12 months postoperatively. Results: The 1-year implant survival rate was 95% for the whole study group: 96.6% for group A, and 93.3% for group B. The bone level increased significantly in both groups (group A: 0.99 ± 0.22 mm; group B: 0.75 ± 0.17 mm), and the difference was not statistically significant (p>0.5). At the 1-year postoperative visit, the mucogingival junction (MGJ) was found to be displaced coronally in 65% of implant sites in group B compared with 15% sites in group A. Conclusions: Both the immediate and delayed loading of immediately placed implants showed similar outcome with regards to treatment success rates and stability of radiographic bone level. Submerging an immediately placed implant and primary soft tissue closure did not show significant outcome advantages over the transmucosal approach.