Loading implants immediately upon insertion in full arch applications has become an encouraging new treatment alternative which can result in increased patient acceptance and reduce both treatment time and management problems. However, effective application of immediate loading in partial edentulism is dependent on whether it can be applied without compromising predictability. Objectives: To determine for immediate implant loading applications in the partially edentulous patient: 1) the correlation of pre-operative bone density as measured on CT Scans with achievement of primary stability as measured by 3 technologies post-implant insertion; 2) whether these technologies are sufficiently sensitive to predict outcome. Methods: 11 implants were placed into healed sites in the anterior and posterior mandibles of 3 patients and immediately loaded at insertion with 4 provisional restorations. Data collection included pre-operative bone density by CT Scan (Hn); and measurement of implant stability by immediate post-insertion final seating torque (Ncm), Periotest® value (PTV), and resonance frequency analysis (ISQ) by Osstell®. Follow-up PTV and ISQ measurements were made at 4-6 months. Results: All implants are osseointegrated and have been in function from 10 to 33 months. Mean pre-operative bone density was 1058.2Hn (range 773 to 1341). Mean final seating torque was 42.7Ncm (range 30 to 45). Mean insertion PTV and ISQ were -5.3 (range -4 to -7) and 71.0 (range 63 to 79) respectively. At 4-6 months post immediate loading, mean PTV and ISQ were -4.6 (range -4 to -5) and 70.3 (range 66 to 76) respectively. Conclusions: Preoperative bone density by CT Scan correlated with postoperative primary stability as determined by final seating torque, periotest value, and resonance frequency analysis. The range of primary stability achieved for the immediately loaded implants studied in these partially edentulous applications was sufficient to allow for successful osseointegration as determined at follow-up.

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