Consensus Statements and Recommended Clinical Procedures Regarding Loading Protocols for Endosseous Dental Implants
Primary authors: David L. Cochran, Dean Morton, Hans-Peter Weber
The group was asked to develop evidence-based reviews on topics related to various loading protocols for dental implants. Three reviews were prepared: the first addressed the literature related to different loading protocols for partially edentulous cases, the second examined the literature for loading protocols in completely edentulous cases, and the third addressed clinical procedures for the various loading protocols. Drafts of the manuscripts were prepared and distributed to the members of the group prior to the conference. The overall objective of the literature review was to determine whether a procedure could be recommended as a standard based on the available evidence. The second objective was to identify whether patients perceived a benefit associated with these procedures.
The literature included full-length articles in English on endosseous root-form titanium implants. For edentulous patients, a minimum follow-up of 1 year was required. The volume of literature found was moderate, but the level of evidence was limited at best for the procedures considered. The predominant literature was case reports. The primary goal was to identify survival of the implants and success or failure of the procedure(s), and to relate these to the implant and/or prosthesis. A secondary goal was to identify possible risk factors for the procedures.
At the consensus conference, the authors presented their manuscripts to the group for discussion. There was discussion concerning how the authors approached writing the draft, how the literature was searched and reviewed, what the major findings were, and finally, what conclusions could be drawn. Following these presentations, group members addressed several aspects of each review, including:
• Did the review adequately address the topic?
• Has any evidence been published since the review that has a significant impact on the topic?
• Do the section members agree with the findings of the review’s authors?
• What open questions remain in this area, and what might be investigated in the future regarding this topic?
• What recommendations can be made for patient treatment with regard to loading protocols?
During the discussion, several statements were made regarding immediate or early restoration and/or loading of implants in edentulous and partially edentulous patients. These are listed below, along with issues that were identified throughout the discussions.