Immediate functional loading in the maxilla using implants with platform switching: Five-year results

Purpose: Immediate loading in the maxilla is not a routinely recommended treatment concept; however, some clinical series have shown a high survival rate for nonfunctionally loaded implants. The purpose of this study was to demonstrate the prognosis for immediately loaded implants with a progressive thread design and platform switching placed in the maxilla with or without simultaneous augmentations using autogenous bone. Materials and Methods: Ninety implants were placed (six in each maxillary arch) in 15 patients. Immediately after surgery, the implants were loaded with a provisional acrylic resin prosthesis (immediate occlusal loading). Splinting of the implants with the provisional remained for 6 to 8 weeks of healing. In patients with augmented sites, a 3-month period of provisionalization was necessary to ensure implant stability; a soft/liquid diet was recommended for this intermediate transitional period. Definitive fixed restorations were then fabricated and delivered. Clinical and radiologic examinations of the implants were performed at various times. Results: After a mean loading period of 42.4 (± 19.15) months, only three failures were reported. This represented a survival rate of 96.66%. No complications, including inflammation or bone loss, were reported during the study period. Conclusions: Based on these results, the immediate loading protocol in the maxilla can be used successfully when implant primary stability, cross-arch stabilization, and a soft diet for the initial stages of healing are considered.