The Hong Kong Bridge Protocol. Immediate Loading of Mandibular Brånemark Fixtures Using a Fixed Provisional Prosthesis: Preliminary Results

Abstract

ABSTRACT Background : The Brånemark System Classic is well documented for its successful and predictable results in dental implant rehabilitation. However, the classic two‐stage protocol is associated with problems, such as long treatment time and high treatment cost. To overcome these problems, new developments, including early functional loading protocol and Brånemark System Novum, have been introduced by various groups of researchers. In Hong Kong, a protocol has been developed to immediately load the Brånemark System fixtures with a fixed provisional prosthesis. Purpose : The goal of this prospective study was to present the Hong Kong Bridge protocol and report the short‐term evaluation of this protocol in a group of patients who had undergone dental implant treatment for their edentulous mandibles. Materials and Methods : Twenty‐seven consecutive patients being treated at the Hong Kong Osseointegration Implant Centre between June 1998 and December 2000 were included in this study. A total of 123 Brånemark System fixtures were installed and regularly followed up for 3 to 30 months. The prosthesis stability and the marginal bone level were regularly evaluated clinically and radiographically, respectively, after the implant surgery. Results : Fifteen of the 27 patients had been followed up for 1 year or longer. Two patients with eight fixtures were withdrawn from the study. Two of the 115 remaining fixtures failed, resulting in an overall implant survival rate of 98.3%. The mean marginal bone change was reported on 49 fixtures that had passed the 1‐year review. The mean marginal bone loss was 0.60 mm ( p <.05) after 1 year of functional loading. Conclusions : To load the mandibular Brånemark System fixtures immediately according to the Hong Kong Bridge protocol was a predictable and simple method with good results during this preliminary study period. CONCLUSION During the preliminary period of this study, 115 immediately loaded Brånemark System fixtures were regularly recalled over 3 to 30 months. The overall implant survival rate of 98.3% demonstrates that immediate loading of mandibular Brånemark System fixtures using a fixed provisional prosthesis can be performed successfully with a predictable outcome.