47
*Department for Fixed and Removable Prosthodontics, University
of Zürich, Zürich, Switzerland;
†
The Institute for Surgical Sciences,
Department of Biomaterials, University of Gothenburg, Gothen-
burg, Sweden
Repring requests: Roland Glauser, DDS, University of Zürich, Dental
School, Clinic for Fixed and Removable Prosthodontics, Plattenstrasse
11, CH-8028 Zürich, Switzerland; e-mail: glauser@zzmk.unizh.ch
©2003 BC Decker Inc
Immediate Occlusal Loading of Brånemark
TiUnite™ Implants Placed Predominantly in Soft
Bone: 1-Year Results of a Prospective Clinical Study
Roland Glauser, DDS;* AnnaKarin Lundgren, DDS, PhD;
†
Jan Gottlow, DDS, PhD;
†
Lars Sennerby, DDS,
PhD;
†
Michael Portmann, DDS;* Petra Ruhstaller, DDS;* Christoph H.F. Hämmerle, DDS*
ABSTRACT
Background: The original Brånemark protocol for dental implant treatment was based on submerged healing prior to
loading. However, immediate loading has been reported possible with high success rates for various indications, provided
that good bone quality and quantity are present. In many of these studies, machined-surface implants have been used.
Recently, a new surface texture has been developed, based on an oxidation processing, that aims to enhance the early
bone response (Brånemark System® Mk IV TiUnite™, Nobel Biocare AB, Gothenburg, Sweden). It has been documented
that this surface texture may help to better maintain primary implant stability during the early healing period and that
secondary implant stability can be reached earlier compared with results when using a machined surface. Such a positive
influence on implant stability might be an advantage when applying an immediate-loading protocol, especially in soft
bone regions where a tendency toward reduced success rates has been reported.
Purpose: The aim of this report was to present the short-term success rates of TiUnite-surfaced immediate occlusally
loaded Brånemark System Mk IV implants placed in various regions of the jaws.
Materials and Methods: Thirty-eight patients received a total of 51 prosthetic reconstructions, all of which were connected
on the day the implants were inserted. Of these, 20 were single-tooth restorations, 30 were fixed partial dentures, and 1
was a complete fixed lower jaw restoration. These prostheses were supported by 102 Brånemark System Mk IV TiUnite
implants (38 maxillary and 64 mandibular), the majority of which were placed in posterior regions (88%) and mainly in
soft bone (76%). Cutting resistance measurements were performed during implant insertion, and resonance frequency
measurements were conducted during the course of the study. Furthermore, radiographic examinations were performed
in connection with the delivery of the prostheses and at the 1-, 6-, and 12-month follow-up visits. This article reports on
the results after 1 year of loading.
Results: Three maxillary implants were removed, although stable, in one patient at the 8-week follow-up because of post-
operative infection in the adjacent area of guided bone regeneration (GBR). This resulted in a cumulative success rate of
the implants of 97.1% after 1 year of prosthetic loading. The mean marginal bone resorption after 1 year of loading was
1.2 + 0.9 mm (SD).
Conclusions: The applied immediate loading protocol in combination with a slightly tapered implant and a modified
implant surface texture was shown to be a successful treatment alternative even in regions exhibiting soft bone.
KEY WORDS: bone quality, Brånemark dental implants, guided bone regeneration, immediate loading, oxidized surface
I
mmediate implant loading has been reported lately
as possible with high success rates, provided that
good bone quality and quantity exist.
1–6
A tendency
toward reduced success rates has been reported for
immediately loaded implants placed in soft bone
areas.
3,7
When reviewing articles reporting on immedi-
ate-loading protocols, it becomes clear that most
authors consider a careful and strict patient selection,