Survival and stability of strategic mini-implants with immediate or delayed loading under removable partial dentures: a 3-year randomized controlled clinical trial

Abstract

Abstract Objectives Stability values of mini-implants (MIs) are ambiguous. Survival data for MIs as supplementary abutments in reduced dentitions are not available. The aim of this explorative research was to estimate the 3-year stability and survival of strategic MIs after immediate and delayed loading by existing removable partial dentures (RPDs). Material and methods In a university and three dental practices, patients with unfavorable tooth distributions received supplementary MIs with diameters of 1.8, 2.1, and 2.4 mm. The participants were randomly allocated to group A (if the insertion torque ≥ 35 Ncm: immediate loading by housings; otherwise, immediate loading by RPD soft relining was performed) or delayed loading group B. Periotest values (PTVs) and resonance frequency analysis (RFA) values were longitudinally compared using mixed models. Results A total of 112 maxillary and 120 mandibular MIs were placed under 79 RPDs (31 maxillae). The 1st and 3rd quartile of the PTVs ranged between 1.7 and 7.8, and the RFA values ranged between 30 and 46 with nonrelevant group differences. The 3-year survival rates were 92% in group A versus 95% in group B and 99% in the mandible (one failure) versus 87% in the maxilla (eleven failures among four participants). Conclusions Within the limitations of explorative analyses, there were no relevant differences between immediate and delayed loading regarding survival or stability of strategic MIs. Clinical relevance The stability values for MIs are lower than for conventional implants. The MI failure rate in the maxilla is higher than in the mandible with cluster failure participants. Clinical trial registration German Clinical Trials Register (Deutsches Register Klinischer Studien, DRKS-ID: DRKS00007589, www.germanctr.de), January 15, 2015.