Clinical and Radiographic Outcomes of Immediately Loaded Dental Implants After Tertiary Alveolar Bone Grafting in Non-Syndromic Alveolar Clefts

ObjectiveTo evaluate the clinical and radiographic outcomes of immediately loaded dental implants in patients with non-syndromic alveolar cleft following tertiary alveolar bone grafting (TABG).DesignProspective single-arm interventional clinical study.SettingSingle tertiary care centre.ParticipantsThirty non-syndromic patients (≥16 years) with a missing permanent tooth at the cleft site and previous secondary alveolar bone grafting.InterventionsTABG 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 MeasuresClinical 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.ResultsGraft 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.ConclusionWithin 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.