Clinical and Radiographic Outcomes of Immediately Loaded Dental Implants After Tertiary Alveolar Bone Grafting in Non-Syndromic Alveolar Clefts
Rizwana Mallick, Sweta Kale Pisulkar, Srinivas Gosla Reddy, Vanshika JainObjective
To evaluate the clinical and radiographic outcomes of immediately loaded dental implants in patients with non-syndromic alveolar cleft following tertiary alveolar bone grafting (TABG).
Design
Prospective single-arm interventional clinical study.
Setting
Single tertiary care centre.
Participants
Thirty non-syndromic patients (≥16 years) with a missing permanent tooth at the cleft site and previous secondary alveolar bone grafting.
Interventions
TABG using autologous anterior iliac corticocancellous or mandibular symphyseal grafts, followed by titanium implant placement and immediate non-functional loading based on intraoperative assessment of primary stability, with recording of implant stability quotient (ISQ). Definitive functional loading was performed at 3 months, with final follow-up at 6 months post-loading.
Main Outcome Measures
Clinical parameters (gingival index, plaque index, probing depth, width of keratinized gingiva, bleeding on probing, suppuration, pain/tenderness and mobility) alongside cone beam computed tomography-derived marginal bone loss (MBL) and ISQ, assessed at 3 and 6 months. Implant survival was analysed using Kaplan–Meier analysis.
Results
Graft success was achieved in 25/30 cases (83.3%), with implant placement feasible in 24 (96%). Six implants failed by 3 months follow-up due to mobility; remaining 18 demonstrated significant improvement in all clinical parameters with ISQ increasing from 63.88 ± 8.27 to 68.38 ± 7.90 (P < .001). Mean MBL was 0.38 ± 0.21 mm, within acceptable limits. No further failures occurred following definitive loading. Overall implant survival was 75% (18/24 implants) at 9 months.
Conclusion
Within the limitations of this study, immediately loaded implants demonstrated acceptable short-term clinical and radiographic outcomes following TABG in young adults with non-syndromic alveolar clefts.