Immediate Implant Loading in Healed Ridges Versus Extraction Sockets

Different implant protocols require careful clinical scrutiny. Objective: This multicenter comparative trial seeks to evaluate implant survival using an immediate loading protocol in healed ridges versus extraction sockets. This report concerns 1 year follow up data. Methods: A prospective clinical investigation involving 121 patients in need of 137 single standing anterior maxillary implants is ongoing. Titanium dioxide grit blasted implants modified in diluted hydrofluoric acid (OsseoSpeed^TM), titanium abutments and ceramic crowns were used. After 1 year (baseline =implant placement and provisionalization), 49 and 51 implants in extraction sockets and healed ridges, respectively, were evaluated by clinical and standardized periapical radiographic methods. One implant per patient was analyzed. Results: Three patients have not reached the 1 year follow up visit (1 extraction; 2 healed ridges) and one implant was lost in each group. The mean change in marginal bone level for extraction socket implants was 1.36 (+/- 2.58) mm (gain) and for healed ridge implants it was -0.46(+/-1.53) mm (loss). The resultant bone level (distance to reference point) at 1 year after implant placement in extractions sockets and healed ridges was 1.22 mm (+/- 1.20) and 0.87 mm (+/-0.92) respectively. Conclusion: Under the strict inclusion and exclusion criteria enforced, the treatment of single anterior maxillary teeth using implants placed in healed ridges or directly into extractions sockets followed by immediate provisionalization was successful at 1 year. The accrual of bone relative to the implant reference point followed a different temporal pattern leading to similar results at 1 year.