OPTIMIZATION OF IMMEDIATE AND EARLY LOADING PROTOCOLS FOR DENTAL IMPLANTS TAKING INTO ACCOUNT BONE DENSITY AND OCCLUSAL FACTORS

Rochshin Evgeny Myhailovych

Optimization of immediate and early loading protocols for dental implants is a current challenge in modern dentistry aimed at shortening patient rehabilitation times. The success of these techniques directly depends on bone tissue density and occlusal factors, which determine implant stability and distribution of masticatory loads. The aim of this study was to develop differentiated clinical algorithms to minimize the risk of implant failure under accelerated loading protocols, taking these parameters into account. Methods A prospective clinical study was conducted involving 120 patients (246 implants placed). Bone density was assessed according to the Lekholm & Zarb classification (types D1–D4) based on CBCT. Occlusal factors were analyzed using the T-Scan III system. Patients were divided into groups receiving standard and optimized loading protocols, which included individualized adjustment of masticatory contacts and provisional prostheses. Follow-up evaluations were performed at 3, 6, and 12 months. Results The use of adapted protocols with occlusal adjustment reduced the complication rate in groups with low bone density (D3–D4) by 28% compared to standard methods. Marginal bone loss at one year in the optimized protocol group was 0.8 ± 0.3 mm versus 1.5 ± 0.4 mm in the control group. Implant survival rates reached 98.7% for D1–D2 and 94.2% for D3–D4, compared to 91.5% in groups without occlusal factor correction. Discussion The data confirm the critical influence of bone density and occlusal control on the long-term success of accelerated loading. The developed algorithms, which include staged correction of masticatory contacts and selection of provisional restorations according to bone type, allow for expanded indications for immediate loading even under suboptimal bone conditions. Implementation of these protocols requires careful planning of occlusal interactions during the provisional prosthesis stage.

Keywords:dental implantation, immediate loading, bone density, occlusal analysis, protocol optimization.