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Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews.

Effect of loading time on the success of complete mandibular titanium implant retained overdentures: a systematic review

Review published: 2007.

Bibliographic details: Kawai Y, Taylor J A.  Effect of loading time on the success of complete mandibular titanium implant retained overdentures: a systematic review. Clinical Oral Implants Research 2007; 18(4): 399-408. [PubMed: 17509065]

Quality assessment

The authors concluded that there is no evidence that immediate or early loading of implant-retained overdentures had adverse effects for up to 24 months post surgery when compared to conventional timing of loading, but more research was needed. Given the very small amount of relevant evidence, limited search and methodological weaknesses in the review, the conclusions may not be reliable. Full critical summary


OBJECTIVES: The aim of this review was to compare conventional against early/immediate loading protocols of implant-retained overdentures (IOD) in the edentulous mandible.

MATERIAL AND METHODS: Medline search via Ovid to extract prospective comparative studies on trials comparing the effect of timing of loading initiation on the success of mandibular IOD. The outcome of major interest was marginal bone loss. Probing depth, plaque, bleeding index and mobility were also assessed. Indices at 12 and 24 months were compared and changes assessed. Outcomes were entered into RevMan (version 4.2.5) for meta-analysis.

RESULTS: Of 239 articles, only nine trials fulfilled the criteria and involved 30 immediate, 71 early, 77 one-stage conventional, and 66 two-stage conventional subjects. Three immediate loading trials showed an increase in the amount of marginal bone loss over time, while the majority of early and conventionally loaded implants exhibited a decrease in the amount of bone loss in the second year compared with the first 12-month period. Probing depth at 24 months showed a significant difference between early and conventional loading; SMD 0.5 (95% confidence interval 0.03, 0.97). No other statistically significant differences were found between either immediate or early and conventional loading for any indices.

CONCLUSIONS: No deleterious effects up to 24 months have been shown from immediate or early loading. Conventional loading after a 3-month healing period has not been proven to be the only acceptable protocol for mandibular IOD, but further long-term studies are needed to confirm this.

CRD has determined that this article meets the DARE scientific quality criteria for a systematic review.

Copyright © 2014 University of York.

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