Immediate Loading Showed More Buccal Bone Loss in 5-Year Full-Arch Pilot Trial

Posted: October 8, 2026

Immediate Loading Showed More Buccal Bone Loss in 5-Year Full-Arch Pilot Trial

Edited by Dentaltown staff

Immediate loading of full-arch fixed prostheses in edentulous maxillae produced implant survival comparable to early loading over five years, but significantly greater buccal marginal bone loss. The finding comes from a pilot randomized clinical trial published online Oct. 2 in the Journal of Oral Rehabilitation.

The trial randomized 24 patients and 144 implants, with 12 patients and 72 implants in each group.

Outcome at 5 yearsImmediate loadingEarly loadingP value
Implant survival98.6%97.2%.610
Prosthesis survival91.67%100%.317
Buccal marginal bone loss1.15 mm0.36 mm.010


Bone loss was the only one of these differences that reached significance.

Mechanical complications were also significantly more frequent with immediate loading (P = .015). Four of the five peri-implantitis cases involved immediately loaded implants, though that difference was not significant (P = .310). Peri-implant mucositis affected 55.32% of implants and was evenly distributed. Patient satisfaction stayed high in both groups.

The authors concluded that both protocols can be considered viable for maxillary rehabilitation when primary stability is adequate, with immediate loading producing more buccal bone loss.

The investigator-initiated study was conducted at the University of Belgrade School of Dental Medicine. According to the authors’ disclosure, Straumann provided financial support along with implants, parts, and components, and co-author Michel Dard is an employee of the Straumann Institute and Columbia University College of Dental Medicine.

The authors describe the trial as a pilot. Three participants discontinued before the five-year follow-up, and the trial was registered after recruitment and randomization.

Sources:
Journal of Oral Rehabilitation, “Immediate Versus Early Loading Protocols in Rehabilitation of Fully Edentulous Maxilla: A 5-Year Pilot Randomized Clinical Trial,” published online Oct. 2, 2026:
onlinelibrary.wiley.com/doi/10.1111/joor.70330
PubMed, PMID 42827082:
pubmed.ncbi.nlm.nih.gov/42827082


Immediate Loading Showed More Buccal Bone Loss in 5-Year Full-Arch Pilot Trial

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