Immediate Loading in Mandible Full-Arch: Pilot Study in Patients With Osteoporosis in Bisphosphonate Therapy

Abstract Aim: The aim of this paper was to show how it was possible to achieve full-arch dental implant immediate loading rehabilitation in the mandible for patients being treated with biphosphonates. Materials and methods: Nine adult patients (8 women and 1 man) aged 45 to 68 years presented for rehabilitation of the edentulous mandible. All patients were non-smokers with non-contributery medical histories. None of the patients had a history of chemotherapy or radiation therapy. All patients had been demonstrated osteoporotic disease (t-scan < 2,5) and were being treated with bisphosphonates per os (Residronate and Alendronate) for less than 3 years. All patients had residual teeth that were periodontally compromised. All patients were rehabilitated in mandible with a fixed full-arch prosthesis supported by six Way Syntegra ® implants. Results: No subjective complaints were reported throughout the follow-up period. After 2 years of loading, all implants were examined and found to be clinically stable without signs of infection. During the same period, no soft tissue swellings or osteonecrosis lesions were noted. The clinical survival rate is 100% in this interval. Conclusion: Rehabilitation of the edentulous mandible in these nine patients being treated with oral bisphosphonates and restored with an immediate occlusally loaded full-arch prosthesis supported by six Way Syntegra ® implants proofed to be a viable alternative treatment to the classical delayed placement and load protocols.