Clinical Outcomes and Stability Changes Associated With Immediate loading Of Two Different Installation Protocols

Problem statement
The wide variation of implant installation protocols combined with immediate implant loading have a pivotal impact on implant stability and success. This study was conducted to assess immediate implant loading on stability changes and clinical outcomes of two different installation protocols.
Patient and Method: Sixteen patients; nine females and seven males seeking for dental implants and patient were divided equally into two groups. In 1^st group, eight dental implants were placed 6-8 weeks after extraction of non-restorable tooth in the lower posterior region. While, in 2^nd group, eight dental implants were placed in healed sites (more than 3 months) after extraction in the lower posterior region. All implants were subjected to immediate loading within (48-72) hours after fixture installation. All patients were assessed clinically either at baseline (T0), 3 months (T1), at 6 months (T2) and 12 months (T3) of follow up regarding to Implant stability by Osstell and Periotest, radiographically for assessment of marginal bone level (MBL). Modified bleeding index, Modified plaque index and peri-implant pocket depth were assessed at the same time intervals of evaluation.
Result: There was significant differences were recorded between both groups regarding to implant stability by osstell at (T0) (P=0.004). However, there were no statistical significant differences recorded at (T1) and (T2) intervals of follow up (P=0.870, 0.201 respectively), on other hand, periotest value showed no statistical significant differences between both groups at (T0), (T1), (T2) and (T3) (P=0.490, 0.914, 0.063 and 0.098 respectively). A significant correlation was established between ISQ and PTVs at (T0) in control group in comparison with lack of significant correlation between both of ISQ and PTVs in study group for same time interval of assessment. No significant differences were recorded between both groups regarding to mSBI, PI, MBL and PIPD at different time intervals of follow up periods either at, (T0), (T1), (T2) and (T3) (P=1.000, 0.880, 0.838 and 0.077 respectively), (P=1.000, 0.789, 0.838 and 0.211 respectively), (P=0.400, 0.863 and 0.136 respectively) and (P=0.099, 0.204 and 0.080 respectively),.
Conclusion:Osstell and Periotest systems proved to be a sensitive implant stability assessment tools. However, Osstell can be considered as a more precise and reliable fingerprint tool rather than periotest, especially when immediate loading pattern will be used.