Implant loss and crestal bone loss in immediate versus delayed load in edentulous mandibles: A systematic review and meta-analysis.

STATEMENT OF PROBLEM: The current trend is to shorten the loading times of dental implants. However, information about the risk of early loss of implants that have been loaded immediately is scant if compared with data available for those conventionally loaded. PURPOSE: The purpose of this systematic review and meta-analysis was to study immediate (IL) and delayed loading (DL) protocols in edentulous mandibles to determine whether differences exist in implant success and crestal bone loss and to evaluate these possible differences in relation to the type of prosthesis and the splinting of the implants. MATERIAL AND METHODS: The literature review was conducted in PubMed, Scopus, and the Cochrane Library. Nine randomized clinical trials were included. RESULTS: The result of a meta-analysis of implant loss before 1 year was 2.63 (95% CI: 1.22, 5.68), favoring the DL control group, while the outcome for crestal bone loss at the observation year was 0.42 (95% CI: -0.35, 1.20), with a tendency toward reduced bone loss for DL. CONCLUSIONS: The risk of early loss in the IL group was higher than that in the DL group. For removable prostheses and nonsplinted implants, DL was preferred. The quality of scientific evidence significantly favors DL.