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Meta-Analysis investigating the influence of loading protocols on mandibular implant success and patient satisfaction

1   Ali Raza, 2Dr. Farzeen Khan, 3Mohib Ali, 4Maryam Akram, 5Dr. Arslan Mehmood, 6Dr. Bakhtawar Saleem

1PIMS

2Associate Professor, Community & Preventive Dentistry Department, Peshawar Dental College, Riphah International University, Islamabad.

3PIMS

4Prosthodontic Department, Bakhtawar Amin Dental Hospital

5Assistant Professor, Department of Oral & Maxillofacial Surgery, Liaquat institute of Medical & Health Sciences

6Senior Registrar, Department of prosthodontics, Liaquat Institute of Medical & Health Sciences

Correspondence: Ali Raz, PIMS   

Abstract

Background: Mandibular implants have revolutionized dental rehabilitation, but the optimal loading protocols for ensuring implant success and patient satisfaction remain debated. Various loading protocols, including immediate, early, and conventional loading, have been proposed, each with its advantages and drawbacks.

Aim: This meta-analysis aimed to investigate the influence of different loading protocols on mandibular implant success rates and patient satisfaction levels.

Methods: A comprehensive literature search was conducted in major databases from May 2023 to April 2024. Studies comparing different loading protocols for mandibular implants were included. Quality assessment and data extraction were performed independently by two reviewers. Statistical analysis was carried out using random-effects models to calculate pooled estimates of implant success rates and patient satisfaction levels.

Results: A total of 15 studies involving 120 participants were included in the meta-analysis. The pooled implant success rate was 93.5% (95% CI: 91.2% to 95.6%) across all loading protocols. Immediate loading showed the highest success rate at 95.8% (95% CI: 93.2% to 97.6%), followed by early loading at 93.4% (95% CI: 89.9% to 95.8%), and conventional loading at 91.7% (95% CI: 88.4% to 94.2%). Patient satisfaction levels were also favourable across all loading protocols, with immediate loading demonstrating the highest satisfaction rate (mean satisfaction score: 4.7 out of 5), followed by early loading (mean satisfaction score: 4.5 out of 5), and conventional loading (mean satisfaction score: 4.3 out of 5).

Conclusion: This meta-analysis suggests that immediate loading may offer slightly higher implant success rates and greater patient satisfaction compared to early and conventional loading protocols for mandibular implants. However, all loading protocols demonstrated favourable outcomes, indicating that the choice of loading protocol should be tailored to individual patient needs and clinical circumstances.

Keywords: Mandibular implants, loading protocols, meta-analysis, implant success, patient satisfaction

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