Immediate Versus Conventional Loading of Complete-Arch Implant-Supported Prostheses in Mandibles with Failing Dentition: A Patient-Centered Controlled Prospective Study

Purpose: The aim of this study was to compare, from the patients' perspective, immediate and conventional loading of fixed complete-arch prostheses to rehabilitate mandibles with failing dentition. Materials and Methods: This controlled, prospective, nonrandomized study included 36 consecutive patients: 18 treated with conventional loading (control) and 18 with immediate loading (test). Patient general satisfaction and specific satisfaction with esthetics, chewing, speaking, comfort, self-esteem, ease of cleaning, and treatment duration were evaluated using 10-cm visual analog scales before treatment and 3 and 12 months after treatment. Postoperative pain and swelling were monitored daily for 1 week. Statistical analysis was performed applying Mann-Whitney and Wilcoxon tests (alpha =.05). Results: Between baseline and 3 months, satisfaction in the test group increased significantly with the exception of speech; in the control group, satisfaction increased significantly for esthetics and decreased significantly for speech, chewing, and comfort, but did not vary for general satisfaction or self-esteem. After 3 months, satisfaction was significantly higher in the test group with the exception of ease of cleaning. Between 3 and 12 months, satisfaction improved in both groups but more so in the control group, so that after 12 months there were no differences. The test group showed lower mean pain, which began after the third day postsurgery. Mean swelling and maximum pain/swelling did not show significant differences at any point. Conclusions: Patient satisfaction was reported as significantly higher with immediate loading. However, at the end of the observation periods, reported functional differences had disappeared. Significant differences were only noted for postoperative pain after the third day.