Immediate versus early loading of single dental implants: A systematic review and meta-analysis

Statement of problem. Patients prefer to be rehabilitated as soon as possible if the risk of implant failure is not increased. However, whether immediate loading of single implants is riskier than early loading is not clear. Purpose. This systematic review and meta-analysis investigated whether the immediate loading protocol has more clinical disadvantages than the early loading protocol for single dental implants in terms of the marginal bone loss and survival rate of single implant crowns. Material and methods. Two reviewers conducted an advanced electronic database search, with no language or date restriction, in Medline/PubMed, Embase, and the Cochrane Library up to May 2016. Studies were chosen by title and abstract for screening in accordance with the following inclusion criteria: dental implants studies; cohort studies (prospective and retrospective) and randomized controlled trials; samples involving partially edentulous patients; immediate loading implants; early loading implants; and n >= 10 participants. Results. Of the 5710 studies initially identified, 5 fulfilled the inclusion criteria. A meta-analysis yielding risk differences (RD) and mean differences (MD) with a 95% confidence interval (CI) was performed. The trials included showed no significant differences between early and immediate loading protocols in single implant crowns with regard to survival rate at 1 and 3 years (RD, 0.00; 95% CI, -0.04 to 0.04; P=.990 for 1 year and P=.980 for 3 years) or marginal bone loss at 1 year (MD, 0.09; 95% CI, -0.02 to 0.19; P=.110) and 3 years (MD, -0.23; 95% CI, -0.47 to 0.01; P=.060). Conclusions. This systematic review showed no significant differences between early and immediate loading protocols in single implant crowns with regard to survival rate or marginal bone loss at 1 or 3 years.