***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This study was design ed to compare the results of immediate and delayed loading of implants with implant-retained m and ibular overdentures . Ten patients ( test group ) received 40 Brånemark System MKII implants ( 4 per patient ) placed in the interforaminal area of the m and ible . St and ard abutments were immediately screwed to the implants , rigidly connected with a bar , and immediately loaded with an overdenture . Ten patients ( control group ) received the same type and number of implants in the same area , but the implants were left to heal submerged . Four to 8 months later , st and ard abutments were screwed to the implants and the same prosthetic procedure was applied . Each implant was evaluated at the time of prosthetic loading and at 6 , 12 , and 24 months after the initial prosthetic load with the following parameters : modified Plaque Index ( MPI ) , modified Bleeding Index ( MBI ) , probing depth ( PD ) , and Periotest . Peri-implant bone resorption was evaluated on panoramic radiographs taken 12 and 24 months after initial prosthetic loading . No significant differences were found between the 2 groups regarding MPI , MBI , Periotest , peri-implant bone resorption , and PD at 6 and 24 months ( P > .05 ) . The only difference was found regarding PD values on the mesial and lingual sites at 12 months ( P < .05 ) . The cumulative success rate of implants was 97.5 % in both groups . Results from this study showed that immediate loading of endosseous implants rigidly connected with a U-shaped bar does not seem to have any detrimental effect on osseointegration . Conversely , this method significantly shortens the duration of treatment with relevant satisfaction for the patients The aim of this 1-year study was to evaluate and compare crestal bone loss and clinical outcomes of immediate and delayed loaded implants supporting m and ibular overdentures with Locator attachments . In a r and omised controlled clinical trial , 36 completely edentulous patients ( mean age 59.6 years ) who desired to improve the stability of their m and ibular dentures were r and omly assigned into two groups . Each patient received two implants in the canine area of the m and ible after a minimal flap reflection . Implants were loaded by m and ibular overdentures either 3 months ( delayed loading group , G1 ) or the same day ( immediate loading group , G2 ) after implant placement . Locator attachments were used to retain all overdentures to the implants . Peri-implant vertical ( VBL ) and horizontal ( HBLO ) bone losses and clinical parameters [ plaque scores ( PI ) , gingival scores ( GI ) , probing depths ( PD ) and implant stability ( ISQ ) ] were assessed at time of overdenture insertion ( T0 ) , 6 months ( T6 ) and 12 months ( T12 ) after overdenture insertion . After 12 months of overdenture insertion , two implants ( 5.5 % ) failed in G2 . Vertical bone loss was significantly higher in G2 compared with G1 , while HBLO demonstrated insignificant differences between groups . All clinical parameters ( PI , GI , PD and ISQ ) did not differ significantly between groups . Vertical bone loss was significantly correlated with PD and HBLO . Immediately loaded two implants supporting a Locator-retained m and ibular overdenture are associated with more vertical bone resorption when compared to delayed loaded implants after 1 year . Clinical outcomes do not differ significantly between loading protocol Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Objectives To appraise the feasibility of loading four implants with a pre-existing denture converted to a fixed dental prosthesis ( FDP ) on the day of implant surgery compared with waiting for 3- to 4-month healing . Methods Patients with an edentulous , fully healed m and ible were recruited in a faculty clinic to partake in a blinded two-arm parallel r and omized controlled trial ( RCT ) . The participants received four parallel intraforamina m and ibular implants with a moderately rough titanium surface ( Brånemark System Mk III or Mk IV TiUnite ; Nobel Biocare AB , Göteborg , Sweden ) . The implants were loaded on the same day by converting the participants ' pre-existing denture in the experimental group . The implants were placed using a one-stage surgery procedure , and the participants ' pre-existing denture were soft-relined in the control group . For both groups , the permanent 10- to 12-unit FDP consisting of a type-3 cast precious alloy veneered with acrylic and artificial teeth was placed 3–4 months after implant surgery . All participants have been recalled annually for 5 years for appraisal of bone loss and registration of adverse events . Results Thirty-five of the original 42 participants ( 83 % ) returned for clinical and radiological examinations at the 5-year follow-up recall . No selective dropout or specific reasons for dropout was identified in the two study arms ; leaving n = 17 ( Intention-to-treat group , ITT ) in the experimental group , alternatively n = 13 as per protocol group ( PP ) , and n = 18 participants in the control group ( ITT = PP ) . At study commencement , five of the participants assigned to the experimental group did not receive their planned intervention . In the control group , one implant failed to osseointegrate and another failed due to bone loss after 5 years . The crestal bone level changes over 5 years were identical in the experimental and control groups , that is , 1.2 mm ( SD = 0.7 ) . There were no differences between the two study arms with regard to incidence of biological and technical adverse events . Conclusions Implants in the anterior m and ible loaded immediately with a converted pre-existing denture appear to yield analogous clinical outcomes compared with waiting for 3–4 months over the first 5 years following implant surgery It was the aim of this 24-mo r and omized controlled clinical trial to investigate whether the survival of a single median implant  placed in the edentulous m and ible to retain a complete denture is not compromised by immediate loading . Secondary outcomes were differences in prosthetic complications between the loading principles . Each of the 158 patients who received an implant  was r and omly assigned to the immediate loading group ( n = 81 ) or the delayed loading group ( n = 77 ) . Recall visits were performed 1 mo after implant placement ( for only the delayed loading group ) and 1 , 4 , 12 , and 24 mo after implant loading . Nine implants failed in the immediate loading group , all within the first 3 mo of implant loading , and 1 implant failed in the delayed loading group prior to loading . Noninferiority of implant survival of the immediate loading group , as compared with the delayed loading group , could not be shown ( P = 0.81 ) . Consistent with this result , a secondary analysis with Fisher exact test revealed that the observed difference in implant survival between the treatment groups was indeed statistically significant ( P = 0.019 ) . The most frequent prosthetic complications and maintenance interventions in the m and ible were retention adjustments , denture fractures , pressure sores , and matrix exchanges . There was only 1 statistically significant difference between the groups regarding the parameter “ fracture of the denture base in the ball attachment area ” ( P = 0.007 ) . The results indicate that immediate loading of a single implant  in the edentulous m and ible reveals inferior survival than that of delayed loading and therefore should be considered only in exceptional cases ( German Clinical Trials Register : DRKS00003730 ) BACKGROUND Implant-retained overdentures have become a st and ard option for the prosthetic treatment of the edentulous m and ible in the elderly . PURPOSE This prospect i ve study aim ed to compare immediate and conventional loading of four interforaminal implants supporting a Locator-retained m and ibular overdenture in elderly patients regarding implant survival , implant stability , and implant-related complications . MATERIAL AND METHODS The study population comprised 20 completely edentulous patients ( 11 males ) aged 60 years and older with severe m and ible resorption . Each patient received four interforaminal implants ( Neoss Ltd. , Harrogate , UK ) . Following r and omization , implants were loaded either immediately after dental implant surgery or 3 months after implant placement with the Locator-abutment system . At follow-up visits 3 , 6 12 , 24 , and 36 months after loading , implant stability was evaluated with Periotest and Ostell . RESULTS Twenty patients received 80 implants . In eight patients , 32 implants were loaded immediately . Two patients had to be switched from the immediate to the conventional loading group due to insufficient primary stability ( ≤30 Ncm ) . Implant survival was similar in both groups after 36 months . No implant was lost . Decreasing Periotest , and accordingly , increasing Ostell measurements indicated adequate osseointegration in both groups . The course of treatment was not significantly different in the two groups . There were comparable incidences of postoperative complaints like swelling , hematoma , or wound dehiscence , as well as need for prosthetic treatment due to abutment loosening or occlusal discrepancies . Incidence of pressure marks and number of patient visits were significantly higher in the conventional loading group . CONCLUSION With sufficient primary stability , immediate loading of four interforaminal implants in the edentulous m and ible might be the preferential choice in the elderly , reducing total treatment time , and number of patient visits PURPOSE A 1-year blinded two-arm parallel r and omized controlled clinical trial was conducted to test the null hypothesis that immediate loading of four dental implants between the mental foramina with a fixed prosthesis has no benefits compared with the conventional loading technique in terms of implant success and clinical function . MATERIAL S AND METHODS Forty-five patients , completely edentulous in the m and ibles seeking implant-supported prostheses at the Faculty of Dentistry , University of Toronto , were recruited .  Four TiUnite dental implants ( NobelBiocare ® , Göteborg , Sweden ) were placed following the one-stage surgical protocol . Immediately after surgery , the patients were r and omly assigned to either study arms by a third independent party . In the experimental arm ( EA ) , existing m and ibular denture was converted into an interim implant-supported fixed bridge ( ISFB ) on the same day of surgery . In the control arm ( CA ) , the m and ibular denture was hollowed out and relined with a soft tissue reline . The implants were loaded with the permanent ISFB at least 3 months postsurgery . Patients were assessed by a calibrated independent investigator at 2 , 6 , and 12 months following completion of treatment . RESULTS A total of one hundred sixty implants were placed . Due to anatomical limitations , one patient was excluded from the study . Four patients in the EA did not receive intervention as allocated and were transferred to the CA . Implant success rate was comparable between the two arms and exceeded 96 % . Marginal bone loss was statistically significantly more in the immediate loading arm , -0.296 mm versus -0.037 mm ( intention to treat : p = .002 ; per protocol : p = .021 ) . The relatively early intervention and insertion of the final prosthesis in the immediate arm , when bone healing and remodeling process had not yet been completed , might explain the difference in the amount of bone loss . CONCLUSION Immediate loading of four dental implants with a fixed prosthesis in the edentulous m and ible is a feasible treatment option and leads to a substantial improvement in perceived oral health status OBJECTIVES The aim of this study was to evaluate and compare marginal bone loss and clinical outcomes of conventionally and immediately loaded two implants  supporting a ball-retained m and ibular overdenture . MATERIAL S AND METHODS Thirty six completely edentulous patients ( 22 males and 14 females ) were r and omly assigned into two groups . Each patient received two implants in the canine area of the m and ible after a minimal flap reflection . Implants were loaded by m and ibular overdentures either 3 months ( conventional loading group ) or the same day ( immediate loading group ) after implant placement . Ball attachments were used to retain all overdentures to the implants . Vertical and horizontal alveolar bone losses were evaluated in both groups 1 and 3 years after implant placement using multislice computed tomography , which allow evaluation of peri-implant buccal and lingual alveolar bone . Plaque scores , gingival scores , probing depths and periotest values ( PTVs ) were evaluated at 4 months ( baseline ) , 1 and 3 years after implant placement . Clinical and radiographic evaluations were performed at distal , labial , mesial and lingual peri-implant sites . RESULTS After 3 years of follow-up period , the immediate loading group recorded significant vertical bone loss at distal and labial sites than the conventional loading group and no significant differences in horizontal bone loss between groups were observed . Probing depth at distal and labial sites in the immediate loading group were higher than the conventional loading group , while plaque scores , gingival scores and PTVs showed no significant differences between the two groups . A low level of positive correlation between plaque scores , gingival scores , probing depths and vertical bone loss was noted . CONCLUSION Immediately loaded two implants supporting a ball-retained m and ibular overdenture are associated with more marginal bone resorption and increased probing depths when compared with conventionally loaded implants after 3 years . The bone resorption and probing depths at distal and labial sites are significantly higher than those at mesial and lingual sites . Clinical outcomes do not differ significantly between loading protocol This prospect i ve study has been design ed to compare the results of immediate and delayed loading of 
    Output:
    
The risk of early loss in the IL group was higher than that in the DL group .
For removable prostheses and nonsplinted implants , DL was preferred .
The quality of scientific evidence significantly favors DL