Immediate loading of implants inserted in implant beds prepared with conventional or ultrasonic osteotomy in the esthetic zone: Randomized clinical trial with 12-month follow-up.

Purpose: This randomized clinical trial compared 12-month outcomes of narrow platform implants (NP) or regular platform implants (RP) in beds prepared with conventional versus ultrasonic osteotomy and immediately loaded.

Materials and methods: Patients requiring narrow (3.0 mm) or regular (3.75 mm) implants in the upper esthetic zone were randomly allocated for conventional (10 NP, 15 RP implants) or ultrasonic (10 NP, 15 RP) osteotomy. Primary and secondary implant stability, operation time, patient discomfort, and probing depths were evaluated after different time periods.

Results: Implant bed preparation time was longer (p < 0.001) with ultrasonic osteotomy versus conventional drilling (CD) in both RP and NP groups. Post-operative pain was lesser with ultrasonic preparation on postsurgical days 1 (p = 0.022) and 7 (p < 0.001) in the RP group and days 1, 4, and 7 (p = 0.015, p = 0.019, p = 0.003) in the NP group. Secondary stability at 3 months was higher in the NP group with ultrasonic preparation versus CD (p = 0.002). No significant differences in probing depth were found between 3 and 12 months in either group with either technique. The 12-month success rate was 100% in both groups with both preparations.

Conclusions: Regular diameter implants in beds prepared by ultrasonic osteotomy have comparable primary and secondary stability to those in beds prepared by conventional osteotomy and can be immediately loaded, showing a similar 12-month success rate. Narrow diameter implants placed in beds prepared by ultrasonic osteotomy have comparable primary stability values to those in conventionally prepared beds, but implant stability quotient values were always insufficient for immediate loading.