The main objective of this scientific study is to evaluate the short-term (1-year) survival and success rates of dental implants restored immediately compared to implants restored after a three-month healing period. The total duration of the study is 12 months following implant placement, during which clinical and radiographic evaluations will be carried out at different follow-up time points.
The present study aims to prospectively and in a controlled manner evaluate the short-term (1-year) survival and success rates of immediately restored dental implants compared with implants restored after a three-month healing period. The study will be conducted at the Faculty of Dental Medicine of the University of Porto, under the coordination of Professor Ricardo Faria de Almeida, in collaboration with MIS Implants Technologies Ltd. Working Hypothesis The null hypothesis of the present study states that both clinical groups will present similar implant survival rates at the end of one year of follow-up. Materials and Methods Study Design The present study was designed as a non-interventional, prospective, randomized, controlled clinical study with two parallel groups, intended to compare the clinical and radiographic performance of implants rehabilitated with immediate loading versus implants rehabilitated after a three-month healing period. Outcome Variables Primary objective: Implant survival rate at 12 months. Secondary objectives: Implant success rate at 12 months. Prosthetic success rate at 12 months. Marginal bone level changes at 6 and 12 months after implant placement, assessed on standardized intraoral radiographs. Implant insertion torque. Esthetic evaluation according to the Pink Esthetic Score (PES) and White Esthetic Score (WES). Sample Size The study will include 50 patients. Target Population Partially edentulous patients who are candidates for rehabilitation with osseointegrated implants in either arch, anterior or posterior to the canine region, will be included. Study Devices MIS LYNX implants (MIS Implants Technologies, Israel), supplied with single-use drills. CONNECT abutments. Healing abutments and provisional abutments for CONNECT. Screw-retained provisional crowns. M-GUIDE surgical guide system (used when clinically necessary). Study Duration Each participant will be followed for a period of 12 months after implant placement. The study is expected to be completed by December 30, 2027. Inclusion and Exclusion Criteria Inclusion Criteria Men and women between 18 and 70 years of age. Ability to read, understand, and sign the informed consent form. Need for placement of one or more implants for fixed prosthetic rehabilitation in either arch. Insertion torque ≥ 35 Ncm (lower values will be excluded from the study). Adequate bone dimensions to receive an implant with diameter ≥ 3.75 mm and length ≥ 10 mm. Bone type I to III at the insertion site. Good oral hygiene: FMBS and FMPS ≤ 25%. Systemic status classified as ASA I or II. Exclusion Criteria Inability to attend follow-up appointments. Systemic contraindications to oral surgery (ASA III or IV). Pregnancy or breastfeeding. Chronic use of corticosteroids, bisphosphonates, or RANKL inhibitors within the last year. Alcohol or drug abuse. Heavy smoking (≥ 10 cigarettes/day). Previous radiotherapy in the cervicofacial region. Untreated active periodontal disease. Absence of antagonist teeth. Local pathology at the planned implant site. Uncontrolled diabetes mellitus (HbA1c \> 7%). Bone type IV at the surgical site. Ethical Considerations This study will be conducted in accordance with the Declaration of Helsinki and Good Clinical Practice guidelines.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
50
Placement of a Lynx CONNECT dental implant following the standard surgical protocol. Attachment of a healing abutment (\~1 mm above the soft tissue) instead of immediate restoration. Healing abutment remains in place for 3 months until final impression is taken for definitive crown fabrication. Post-operative care: antibiotics (amoxicillin 1.5 g/day or clindamycin 900 mg/day for 3 days), chlorhexidine rinse 0.2%, ibuprofen up to 1.2 g/day. Follow-up visits at 10-14 days, 3 months, 6 months, and 12 months for clinical and radiographic assessment.
Placement of a Lynx CONNECT dental implant following the standard surgical protocol. Immediate attachment of a temporary screw-retained crown on the implant abutment (CONNECT). Occlusion adjusted to avoid full contact with antagonist teeth. Temporary crown will remain for 3 months until final impression is taken for definitive crown fabrication. Post-operative care: antibiotics (amoxicillin 1.5 g/day or clindamycin 900 mg/day for 3 days), chlorhexidine rinse 0.2%, ibuprofen up to 1.2 g/day. Follow-up visits at 10-14 days, 3 months, 6 months, and 12 months for clinical and radiographic assessment.
Faculdade De Medicina Dentaria da Universidade do Porto
Porto, Portugal
Implant survival rate
Any implant removed after placement will be considered a failure, whatever the reason. Implant survival will be evaluated clinically and radiographically by counting the remaining implants. The implant survival rate will be calculated by dividing the number of non-failures by the number of installed implants. In addition, the implant survival rate will be calculated at the patient level and on an implant level.
Time frame: - Immediately after placement (Visit 1) - confirm placement - 10-14 days post-op (Visit 2) - 3 months ±14 days (Visit 3) - 6 months ±2 weeks (Visit 5) - 12 months ±2 weeks (Visit 6)
Implant success rate
Defined as probing depth (PD) \< 6 mm together with the absence of bleeding or suppuration on probing and a radiographic marginal bone level (MBL) \< 1.5 mm.
Time frame: - Immediately post-insertion (Visit 1) - 10-14 days post-op (Visit 2) - 3 months ±14 days (Visit 3) - 6 months ±2 weeks (Visit 5) - 12 months ±2 weeks (Visit 6)
Prosthetic success
Defined as the presence of the definitive prosthesis with patient satisfaction and without complications, including and not limited to fracture/chipping, screw loosening, and prosthesis mobility.
Time frame: - 3 months ±14 days (Visit 3) - 6 months ±2 weeks (Visit 5) - 12 months ±2 weeks (Visit 6)
Implant insertion torque
Using a motor device or a torque-controlled hand rachet
Time frame: Immediately at implant placement (Visit 1)
Marginal bone changes
Measured on parallel intra-oral radiographs using computer software. Marginal bone level alterations will be determined from radiographs and expressed as the distance from the implant reference point (shoulder) to the most coronal bone-to-implant contact on the mesial and distal side of the implant.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: - 3 months ±14 days (Visit 3) - 6 months ±2 weeks (Visit 5) - 12 months ±2 weeks (Visit 6)
A pink esthetic score/white esthetic score (PES/WES)
At 1 year after the definitive prosthesis placement by an independent examiner by following the Belser's classification. The score can range between 0 and 10 for both PES and WES.
Time frame: - 12 months ±2 weeks (Visit 6)
7.1 Clinical measurements - Gingival index
Gingival index - Silness and Loe. Using a plastic probe Scale: 0: Normal gingiva. No inflammation, no bleeding. 1. Mild inflammation. Slight change in color, slight edema, but no bleeding on probing. 2. Moderate inflammation. Redness, edema, and glazing; bleeding on probing. 3. Severe inflammation. Marked redness and edema, ulceration, and tendency toward spontaneous bleeding.
Time frame: - Screening (Visit 0b) - 3 months ±14 days (Visit 3) - 6 months ±2 weeks (Visit 5) - 12 months ±2 weeks (Visit 6)
7.2 Clinical measurements - Probing Pocket depth (PPD
Probing Pocket depth (PPD) of the implant at 4 sites (M, D. B, L/P) - using a plastic probe. The scale start at 1mm and can range until 15 mm.
Time frame: 3 months ±14 days (Visit 3) 6 months ±2 weeks (Visit 5) 12 months ±2 weeks (Visit 6)]
7.3 Clinical measurements - Bleeding on Probing
Bleeding on Probing (BoP) of the peri-implant tissue at 4 sites (M, D. B, L/P) - using a plastic probe Scale - presence or absence of bleeding
Time frame: 3 months ±14 days (Visit 3) - 6 months ±2 weeks (Visit 5) - 12 months ±2 weeks (Visit 6)
7.4 Clinical measurements (using UNC periodontal probe)
Suppuration of the peri-implant tissue at 4 sites (M, D. B, L/P) - using a plastic probe. Scale - presence or absence of suppuration.
Time frame: 3 months ±14 days (Visit 3) - 6 months ±2 weeks (Visit 5) - 12 months ±2 weeks (Visit 6)
Safety Measurements - Avaluation
At each visit, scheduled or unscheduled, the subject will be asked an open question: "Have you had any oral or general health problems since the previous visit?"
Time frame: - Immediately post-insertion (Visit 1) - 10-14 days post-op (Visit 2) - 3 months ±14 days (Visit 3) - 6 months ±2 weeks (Visit 5) - 12 months ±2 weeks (Visit 6)