A 5-year prospective multicenter study on 1-stage smooth-surface Branemark System implants with early loading in edentulous mandibles

Purpose: The purpose of the current prospective multicenter Study was to evaluate the 5-year implant success and peri-implant conditions of smooth-surface Branemark System implants when using a novel technique including a 1-stage surgical procedure with early loading in edentulous mandibles. Materials and Methods: The study protocol included 1-stage surgery as well as placement of the definitive prosthesis within 6 weeks after implant insertion (ie, early loading). Clinical evaluation, as well as evaluation of function and esthetics, was performed at each follow-up visit. Radiographs were obtained at connection of the prostheses and at the 1-, 3-, and 5-year check-ups. Results: A total of 40 patients with a mean age of 56 years (range, 30 to 70) were included in the study. In all, 170 implants were placed in between the mental foramina, of which 120 implants in 30 patients were associated with overdenture treatment and 50 implants in 10 patients with fixed complete dentures. Twelve implants failed in 6 patients. The cumulative implant survival rate was 92.9% after both 1 and 5 years of follow-up. Another 3 implants were recorded as mobile but still in function when individually checked at the 5-year visit, which resulted in a cumulative success rate of 91.0%. Mean bone remodeling over the study period was less than 0.1 mm/y after the first year of loading, resulting in a mean marginal bone level of 0.66 mm (SD 0.73, n = 138) apical to the? implant collar reference point after 5 years. Conclusions. One-stage, early loaded smooth-surface Branemark System implants functioned well for the majority of patients with edentulous mandibles. Stable peri-implant conditions were observed. Bone remodeling resulted in a mean bone level above the first implant thread after 5 years. The somewhat lower success rate of 91.0% compared to a 2-stage procedure may be related to generous inclusion criteria and to a learning curve involving a novel treatment procedure.