Comparative Evaluation of Implant Stability in Single Tooth Implant with Either Immediate or Delayed Functional Loading Protocol: A Prospective Clinical Study

Original researchthe prosthetic restoration is kept out of occlusal contact to allow a safer healing period, though minimal load from mastication and surrounding musculature may still be transmitted to the implant. 12n both situations, immediately loaded implants experience greater stresses and strains during the healing phase compared IntroductIonCurrently, dental implants represent the most common treatment option for replacing missing teeth, demonstrating a survival rate of approximately 95% in most long-term studies. 1 The success of implant therapy primarily depends on implant stability, which serves as an indirect indicator of osseointegration. 2,3The predictable osseointegration of dental implants relies on various factors, one of which is bone of adequate trabecular density that can be assessed in Hounsfield units (HU) by using quantitative cone beam computed tomography (qCBCT). 4There should be adequate torque during implant insertion, necessary for the initial implant stability. 5A significant relationship exists between bone density and insertion torque (IT), as both factors play a crucial role in determining implant stability. 6Implant stability is observed at two stages: primary stability and secondary stability.Primary stability is an initial stability measured immediately after implant placement that is associated with the mechanical engagement of an implant to the surrounding bone. 7Whereas, secondary stability is a biological phenomenon resulting from the bone remodeling seen during the healing phase.Secondary stability depends upon adequate primary stability, a useful predictor for osseointegration. [8][9]][10] It further contributes to the long-term success of implant treatment, and high primary stability makes immediate loading (IL) more predictable. 11IL may be functional or nonfunctional.In immediate functional loading, the implant-supported prosthesis maintains both static and dynamic occlusal contacts, thereby transmitting masticatory forces and muscular forces directly to the implant. 12Conversely, in immediate nonfunctional loading,