***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: PURPOSE To compare the efficacy of immediate functionally loaded implants placed with a flapless procedure ( test group ) versus implants placed after flap elevation and conventional load-free healing ( control group ) in partially edentulous patients . MATERIAL S AND METHODS Forty patients were r and omized : 20 to the flapless immediately loaded group and 20 to the conventional group . To be immediately loaded , implants had to be inserted with a minimum torque > 45 Ncm . Implants in the immediately loaded group were provided with full acrylic resin temporary restorations the same day . Implants in the conventional group were submerged ( anterior region ) or left unsubmerged ( posterior region ) and were left load-free for 3 months ( m and ibles ) or 4 months ( maxillae ) . Provisional restorations were replaced with definitive single metal-ceramic crowns 1 month postloading . Outcome measures were prosthesis and implant failures , biological and prosthetic complications , postoperative edema , pain , and use of analgesics . Independent sample chi2 tests , Mann-Whitney tests , t tests , and paired t tests were used with a significance level of .05 . RESULTS Fifty-two implants were placed in the flapless group and 56 in the conventionally loaded group . In the flapless group , 1 flap had to be raised to control the direction of the bur and 1 implant did not reach the planned primary stability and was treated as belonging to the conventional group . After 3 years no dropouts or failures occurred . There was no statistically significant difference for complications ; however , patients in the conventional group had significantly more postoperative edema and pain and consumed more analgesics than those in the flapless group . Osstell values were significantly higher at baseline in the flapless group ( P = .033 ) . When comparing baseline data with years 1 , 2 , and 3 within each group , mean Osstell values of the flapless group did not increase , whereas there were statistically significant increases in the Periotest values . CONCLUSIONS Implants can be successfully placed flapless and loaded immediately without compromising success rates ; the procedure decreases treatment time and patient discomfort The aim of this study was to compare the success rates after 1 and 2 years of conventionally and early loaded pairs of unsplinted ITI implants supporting m and ibular overdentures in edentulous patients . Twenty-four participants ( age range 55 - 80 years ) were r and omly allocated with maximum concealment to two treatment groups . In the first group , the implants were allowed to heal for 12 weeks before being functionally loaded ( control ) and the second group had 6 weeks of healing with identical loading . All participants had new conventional complete maxillary and m and ibular dentures prior to the study . Two s and blasted large-grit acid-etched ( SLA ) surface ITI implants were placed in the m and ibular interforaminal area , following a st and ardized nonsubmerged surgical protocol . After 6 or 12 weeks of healing , matrices were processed into the fitting surface of the pre-existing m and ibular dentures and the implants loaded . Implant success was determined using mobility tests and radiographs taken at baseline and 52 and 104 weeks after surgery . Clinical peri-implant parameters were also documented . Results showed all implants successfully osseointegrated , according to accepted criteria , after 2 years . Mean loss of crestal bone height after 1 year was 0.35 + /- 0.22 mm ( control ) vs. 0.27 + /- 0.18 mm ( test ) . After 2 years this reduced to 0.09 + /- 0.06 mm ( control ) vs. 0.12 + /- 0.17 mm ( test ) . The mean Periotest value after 1 year was -4.9 ( control ) vs.-3.78 ( test ) . After 2 years , the mean resonance frequency value for the control implants was 6797 Hz [ mean implant stability quotient ( ISQ ) = 64.77 ] and for the test implants 6670 Hz ( mean ISQ = 62.0 ) . Shortened loading periods for these ITI implants did not cause any statistically significant differences in osseointegration or peri-implant parameters . We conclude that pairs of unsplinted SLA-surface ITI implants can be successfully loaded with m and ibular overdentures 6 weeks after surgery AIM this study compared the outcome of immediate non-occlusal loading with conventional loading for single implants in the maxillary aesthetic zone . It was hypothesized that immediate non-occlusal loading is not inferior to conventional loading . MATERIAL S AND METHODS sixty-two patients with a missing maxillary anterior tooth were r and omly assigned to be treated with an implant that was either restored with a non-occluding temporary crown within 24 h after implant placement ( the " immediate group " ) or was restored according to a two-stage procedure after 3 months ( the " conventional group " ) . All implants were installed in healed sites . Follow-up visits were conducted after 6 and 18 months post-implant placement . Outcome measures were radiographic marginal bone-level changes , survival , soft tissue aspects ( probing depth , plaque , bleeding , soft tissue level ) , aesthetics and patient satisfaction . RESULTS no significant differences were found between both study groups regarding marginal bone loss ( immediate group 0.91 ± 0.61 mm , conventional group 0.90 ± 0.57 mm ) , survival ( immediate group 96.8 % : one implant lost , conventional group 100 % ) , soft tissue aspects , aesthetic outcome and patient satisfaction . CONCLUSION within the limitations of this study ( sample size , follow-up duration ) , it was demonstrated that , for single implants in the anterior maxilla , the outcome of immediate non-occlusal loading was not less favourable than conventional loading The CONSORT ( Consoli date d St and ards of Reporting Trials ) statement is used worldwide to improve the reporting of r and omized , controlled trials . Schulz and colleagues describe the latest version , CONSORT 2010 , which up date s the reporting guideline based on new method ological evidence and accumulating experience . PURPOSE The aim of this study was to report a clinical comparative assessment of crestal bone level change around single implants in fresh extraction sockets in the esthetic zone of the maxilla either immediately loaded or loaded after a delay . MATERIAL S AND METHODS Forty patients were included in a prospect i ve , r and omized study . All patients required 1 tooth extraction ( ie , 1 tooth with a hopeless prognosis ) and were r and omized into either the test group or the control group . Implants were positioned immediately after tooth extraction and were loaded immediately in the test group ( 20 implants ) and after 3 months in the control group ( 20 implants ) . The implant site was prepared , with at least 4 mm of sound apical bone below the implant apex , and the coronal margin of the implant was placed at the buccal level of the bone crest . All implants were 13 mm long ; 30 implants had a diameter of 5 mm , and 10 had a diameter of 3.75 mm . Radiographic examinations were made at baseline , at 6 months , and at 24 months . To compare the mean values between test and control group , a paired t test was performed ( considered statistically significant at P < .05 ) . RESULTS After a 24-month follow-up period , a cumulative survival rate of 100 % was reported for all implants . The control group result ed in a mean mesial bone loss of 1.16 + /- 0.32 mm and a mean distal bone loss of 1.17 + /- 0.41 ( mean bone loss , 1.16 + /- 0.51 mm ) . The test group result ed in a mesial bone loss of 0.93 + /- 0.51 mm and a distal bone loss of 1.1 + /- 0.27 mm ( mean bone loss , 1.02 + /- 0.53 mm ) . No statistically significant difference between control and test groups ( P > .05 ) was found . CONCLUSION The success rate and radiographic results of immediate restorations of dental implants placed in fresh extraction sockets were comparable to those obtained in delayed loading group PURPOSE This prospect i ve r and omized controlled trial aim ed to compare single implant-supported m and ibular molar restorations  using either an immediate or a delayed loading protocol . MATERIAL S AND METHODS Thirty subjects requiring single m and ibular molar replacement were consecutively treated . One implant was placed in each patient . Fifteen subjects were assigned to delayed loading protocol and 15 to immediate loading protocol  according to a r and omization table . After insertion , the delayed loaded implants were connected to a healing abutment and restored after 3 to 4 months of healing without loading . The immediately loaded implants were loaded within 24 hours of surgery with a provisional restoration . The interim prosthesis was placed in centric occlusion . All contacts in lateral excursions were eliminated . At implant placement the maximum value of insertion torque was recorded . Radiographic bone level change was measured on periapical radiographs obtained at the time of implant placement and 12 months after loading . Means of the 2 groups were compared by Student t test and analysis of variance ( ANOVA ) . The level of significance was set at .05 . RESULTS No implants were lost in the delayed loading group ( 0/15 ) , whereas 1 implant failed ( 1/15 ) in the immediate loading group . No differences were observed in relation to implant length or insertion torque between the groups . The average radiographic bone level change after 1 year of function was 1.2 + /- 0.55 mm ( range , 0.5 to 2.6 mm ) and 0.77 + /- 0.38 mm ( range , 0.29 to 1.23 mm ) for the delayed loaded and the immediately loaded implants , respectively . The difference in radiographic bone level change between the delayed and immediate loading groups was statistically significant ( P = .022 ; CI = -0.79 to -0.06 ; Student t test ) . CONCLUSIONS Immediate loading of wide-diameter implants supporting single restorations in m and ibular molar sites seems to be a suitable clinical option . Moreover , the radiographic bone level change observed after 12 months of loading was significantly less for immediately loaded implants BACKGROUND Recent studies have showed that immediate/early loading of dental implants is a clinical ly feasible concept with results similar to those for st and ard two-stage procedures , especially in the m and ible . However , there are only a few studies regarding the immediate/early loading of maxillary implants supporting single-tooth crowns . PURPOSE The aim of this study was to compare the clinical and radiological outcomes of early- and delayed-loaded dental implants  supporting single-tooth crowns in the maxilla . MATERIAL S AND METHODS Twenty-nine patients were consecutively treated between 2000 and 2002 with 59 Brånemark System MK III TiUnite implants ( Nobel Biocare AB , Göteborg , Sweden ) in the maxilla . Two groups were formed according to the loading protocol s. In the test group , definitive implant-supported single crowns were delivered to 19 patients 6 weeks after the implant placement . In the control group , definitive implant-supported single crowns were delivered to 10 patients 6 months after the implant placement . Clinical and radiographic parameters were recorded at baseline , 1 to 4 years . Implant stability measurements have only been performed at 4-year follow-up recall . RESULTS Overall , three implants were lost during the study period . Two implants were lost in the test group including 36 implants , which indicated a survival rate of 94.4 % . One of the lost implants was replaced and then osseointegrated successfully . One implant was lost in the control group during the healing period , which indicated a survival rate of 95.7 % . The average marginal bone loss was 1.11 mm for 56 implants after 4 years . There were no significant differences in marginal bone levels , insertion torque , and resonance frequency values between the two groups . CONCLUSION The results of this study indicate that 6 weeks of early loading period for TiUnite-surface titanium implants in the maxilla is reliable and predictable for this patient population and may offer an alternative to the st and ard loading protocol The aim of this r and omized controlled clinical trial was to compare the efficacy of implants placed with a flapless procedure and restored immediately ( test group ) or early ( 6 weeks ) ( control group ) in partially edentulous patients up to 1 year after loading . Both groups were nonocclusally loaded . Ten patients were included in each group . No patients dropped out and no failures were recorded . Two complications occurred in the early loading group , but both were resolved . It can be concluded that the use of a flapless technique for placing implants in conjunction with nonocclusal immediate loading in select patients can provide excellent clinical results . These preliminary findings should be confirmed by larger r and omized clinical trials PURPOSE Achieving primary implant stability in areas with poor bone density is often challenging to the clinician . Previous research has suggested that modified surgical protocol s might be beneficial in such situations . The objective of the present clinical study was to evaluate the survival rate of implants placed using undersized implant site preparation in areas with poor bone density . MATERIAL S AND METHODS A total of 52 implants were placed in 29 patients . Of the 52 implants , 26 were surgically placed according to the st and ard drilling protocol ( control group ) and 26 were placed in low-density bone using an adapted bone drilling method ( test group ) . The maximum insertion torque values and resonance frequency analysis measurements were also recorded . All implants were examined clinical ly and radiographically at follow-up visits during the study period . Oral hygiene status , bleeding on probing , peri-implant probing depth , and implant survival rate were ass 
    Output:
    
This meta- analysis does not show an effect of the timing of restorations on implant MBL .
The selection of restoration protocol s should be based on factors other than MBL