| Objective: To systematically review the impact of immediate and delayed loading on the implant survival, marginal bone loss, stability of peri-implant soft tissue, esthetics, and patient satisfaction of single-implant crowns.Methods: An electronic search was implemented of studies relating to randomized controlled trials(RCTs) comparing immediate and delayed loading of single-implant crowns and published in PubMed, Science Direct, Cochrane library, Wangfang, VIP and CNKI databases prior to September, 2015. After quality assessment and data extraction of included randomized controlled trials, meta-analysis was performed using RevMan 5.3 software.Results: A total of 14 RCT was included, involving 773 implants, test group(n=379, immediate loading), control group(n=394, delayed loading). There were 14 studies assessing the implant survival at first year of loading between immediate and delayed loading, the meta-analysis found no significant differences [RR =0.99, 95%CI(0.97-1.02), P=0.61]. When assessing the marginal bone loss during the 1 year of function, the result of meta-analysis of 10 RCTs showed no significant differences between two groups[SMD=0.09 mm,95%CI(-0.24- 0.42mm), P=0.59]. The difference of implant survival and marginal bone loss at 2, 3, and 5 years of loading between two groups did not reach statistical significance. Comparing the change of peri-implant soft tissues, esthetics and the patient satisfaction between immediate and delayed loading identified no significant differences.Conclusions: Single-implant crowns under immediate loading had similar implant survival and marginal bone loss with those under delayed loading when implants were inserted with a torque ≥ 20-45 N·cm, the implant stability quotient(ISQ) was ≥ 60-65 and there was no need for simultaneous bone augmentation. Due to lacking of available data regarding the change of peri-implant soft tissues, esthetics and the patient satisfaction,it is difficult to draw clear conclusions. |
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