Bone density in immediate, delayed and progressive implant loading protocols in maxillary posterior region

Aim: Which of the following amongst Immediate, Delayed, Progressive Implant loading protocol is better for implant placement in the maxillary posterior region? Materials and Methods: A systematic review of articles selected from MEDLINE, Ebscohost and Google Scholar was carried out. Additional studies were hand searched. All articles that were published in English or those having detailed summary in English were included. Only those articles that were published between 1st January 1985 and 30th September 2016 were considered. Randomized controlled trials and case studies were included with data on bone density in Immediate, Delayed and Progressive Implant Loading protocols. Results: A total of 54 articles were identified through electronic database searching. 51 articles were obtained after elimination of duplicates which were then screened. 10 full-text articles were accessed for eligibility criteria. 8 trials were identified for inclusion in this review. (Six papers were identified on immediate loading, One paper on delayed loading, Two papers on progressive loading.)This review gives an insight about the different implant loading protocols to assess the bone level changes and bone density in the posterior region of the maxilla. Conclusions: It is possible to load implants successfully in the posterior region of the maxilla using Immediate or Delayed or Progressive Implant loading protocols. Primary implant stability is an important factor for a successful loading procedure. At this stage, it is difficult to draw conclusions concerning the eligibility criteria’s, the implant stability, bone density and bone quality needed. Clinical trials with larger samples in which the confounding factors are controlled is necessary to evaluate our finding. Limitations: Certain studies do not give concrete conclusions due to the failure of implants, bone quality and bone quantity needed, smaller sample sizes, availability of relevant articles in different languages other than English.