Practice-based clinical evaluation of dental implants placed with immediate or delayed loading protocols: One-year follow-up

Adolfo Coelho de Oliveira Lopes, Paulo Guilherme Coelho, Paulo Sérgio Perri de Carvalho, Leonardo Rigoldi Bonjardim, Karin Hermana Neppelenbroek, Ernesto Byron Benalcazar Jalkh, Abbas Zahoui, Estevam Augusto Bonfante

Research output: Contribution to journalArticlepeer-review


We evaluate bone remodeling and prostheses survival of immediately provisionalized with occlusal loading and delayed loading (DL) single implants placed in the posterior region after 1-yr follow-up in dental practic-es. Included in the study are patients selected to receive one regular implant (4 × 10 mm) for single tooth replacement in healed ridge sockets in the mandible and maxilla. Implants are immediately loaded or delayed functionally loaded with metal ceramic crowns, depending on peak insertion torque value. All implants are clinically and radiographically evaluated at T1, immediately postoperatively; T2, 60 d; T3, 180 d; and T4, 360 d. Measurements between implant platform and top of alveolar bone crest at distal and mesial areas are performed using periapical radiographs. Data are statistically evaluated through two-way repeated measures of analysis of variance following post hoc comparisons using the Tukey test (p < 0.05). Ten specialists working in ten different practices treat 36 patients who receive one implant each with internal conical connection (hybrid implant system, 4 × 10 mm) (Emfils; Itu, Brazil). Results show that bone-level alterations in immediate (IM; 0.56 mm; confidence interval [CI]: ± 0.21 mm) and delayed (0.65 mm; CI: ± 0.19 mm) groups are not significantly different (p = 0.515) during the course of the 1-yr observation period. In both groups, statistically significant progressive bone-level remodeling occurs through the evaluated follow-up time points (p < 0.047). All prostheses are rated “alpha,” presenting 100% success at 1-yr follow-up. The loading method does not influence bone-remodeling levels around IM or DL at the posterior region after 1-yr follow-up. No prostheses complications are reported.

Original languageEnglish (US)
Pages (from-to)141-149
Number of pages9
JournalJournal of long-term effects of medical implants
Issue number2
StatePublished - 2019


  • Bone remodeling
  • Delayed implants
  • Dental implant
  • Immediate loading
  • Practice-based research

ASJC Scopus subject areas

  • Biomedical Engineering
  • General Dentistry


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