***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 OBJECTIVES The aim of this prospect i ve cohort study was to evaluate the success rate of titanium screw-type implants with the s and blasted and acid-etched ( SLA ) surface loaded early , after 6 weeks of healing . MATERIAL AND METHODS A total of 104 implants were inserted into posterior sites of 51 partially edentulous patients exhibiting bone densities of class I-III . After a healing period of 6 weeks , all implants were functionally loaded with cemented crowns or fixed partial dentures . The patients were recalled at 3 , 12 , 24 , 36 , 48 and 60 months for clinical and radiographic examination . RESULTS One implant failed to integrate during healing , and three implants were lost to follow-up and were considered drop-outs . The remaining 100 implants showed favorable clinical and radiographic findings at the 5-year examination . The peri-implant soft tissues were stable over time ; the mean probing depths and mean attachment levels did not change during the follow-up period . None of the radiographs exhibited signs of continuous peri-implant radiolucency , which confirmed ankylotic stability for all 100 implants . The measurement of the bone crest levels ( DIB values ) indicated stability as well . Based on strict success criteria , all 100 implants were considered successfully integrated , result ing in a 5-year success rate of 99 % . CONCLUSION This prospect i ve study using an early loading protocol with 6 weeks of healing demonstrated that titanium implants with the SLA surface can achieve and maintain successful tissue integration with high predictability for at least 5 years of follow-up in selected patients and sites PURPOSE The aim of this study was to report on the rehabilitation of partial edentulism with immediate function implants placed in predominantly soft bone with flap and flapless surgical techniques . MATERIAL S AND METHODS The prospect i ve clinical study comprises 72 implants ( 50 in the maxilla and 22 in the m and ible ) placed in 41 consecutively included patients rehabilitated from partial edentulism , followed for 1 year . An implant specially design ed for immediate function was used . The evaluation included clinical examinations and radiographic assessment of the marginal bone level at 6 months and 1 year . The outcome measure was the implant success , evaluated using the following implant success criteria : clinical stability ( fixed dental prostheses removed and implants individually checked ) ; fulfilled purported function without any discomfort to the patient ; no suppuration or infection present ; no radiolucent areas around the implants at time of evaluation ; and no aesthetic complaints from the patient . RESULTS No dropouts were registered during the follow-up of the study . The overall cumulative survival rate at 1 year was 98.6 % ( 1 implant lost ) , with 100 % for the implants placed with the flap surgical technique , and 96.9 % for the implants placed with the flapless surgical technique . The overall average marginal bone resorption was 1.6 mm ( SD=1.1 mm ) at 1-year follow-up , with 1.4 mm ( SD=0.8 mm ) and 2.0 mm ( SD = 1.4 mm ) for the flap and flapless surgical technique study groups , respectively . The complications registered were : peri-implant pathology ( 3 implants in 3 patients ) ; fracture of the provisional crown/prosthesis ( 2 patients ) ; crown loosening ( 1 patient ) and prosthetic screw loosening ( 1 patient ) . CONCLUSIONS The placement of the specially design ed implant for immediate function in predominantly soft bone is viable , as given by the overall 98.6 % cumulative survival rate , and the rehabilitation using flapless surgery is safe and predictable . However , the flapless technique revealed more marginal bone resorption compared with the flap technique . Extra care should be taken in the flapless approach with respect to the inclusion criteria and difficulty of the surgery PURPOSE The aim of the present study was to evaluate the concept of an immediate loading protocol in the posterior maxilla and m and ible through analysis of implant survival at 1 year . MATERIAL S AND METHODS One year follow-up data of a multicenter study are reported . Eighty-two ITI s and blasted , acid-etched ( SLA ) implants in 40 patients were loaded between 0 and 11 days after implant placement ( mean 4.3 + /- 2.8 days ) . The restorations consisted of either 2 splinted crowns or a 3-unit fixed prosthesis . All restorations were put into full functional occlusion . Periapical radiographs were evaluated for changes in crestal bone level from baseline to 1 year postloading . Primary stability of the implants was checked initially and before the fitting of the definitive prosthesis . The restorations were evaluated by the practitioners for retention , stability , and esthetics . RESULTS Three patients ' implants were not loaded because of lack of primary stability , and a fourth patient was excluded from the study because of a protocol violation ( more than 4 implants were used ) . All 4 patients were successfully treated outside the protocol . The overall survival rate of the remaining implants at 1 year was 98.8 % . The mean bone loss at 1 year was 0.52 + /- 0.98 mm , which is within the reported limits of less than 1 mm ( range 0.4 to 1.4 mm ) loss in the first year . DISCUSSION AND CONCLUSION The early results from this study indicate that early and immediate loading of 2 implants in the posterior maxilla and m and ible may be suitable in selected patients . On the basis of 1 year of observation , the results appear similar to those achieved with a delayed procedure OBJECTIVE The aim of this prospect i ve study was to evaluate the outcome of immediately provisionally restored implants in the posterior m and ible after a minimum of 60 months in function . MATERIAL AND METHODS Twenty-four patients were treated with 40 screw-type implants replacing m and ibular molars and premolars .  Implants were provisionalized immediately after placement . Radiographic coronal bone levels , implant survival and success were evaluated 12 , 24 , 36 , 48 and 60 months after the final restoration . RESULTS Measurements of the mean marginal bone levels around immediately loaded implants after 12 months showed a significant bone loss ( P<0.001 ) within the first year after the final restoration . Measurements of coronal bone levels after 24 , 36 , 48 and 60 months , respectively , showed no further significant increase of bone resorption . Two implants were lost within the first year after the final restoration , result ing in an overall survival rate of 95 % ; a total of three implants were recorded as failures ( two implant losses and one excessive bone resorption above 50 % ) , result ing in an overall success rate of 92.5 after an implant observation period of up to 8 years . CONCLUSION The present data revealed results comparable to conventionally loaded implants . Careful patient selection in combination with high primary stability seem to be key factors for immediately loaded implants . Larger long-term r and omized clinical trials are needed to confirm the final evidence of this protocol as the st and ard treatment concept for the partially edentulous m and ible PURPOSE To compare peri-implant bone and soft-tissue levels of immediately non-occlusally loaded versus non-submerged early loaded implants  in partially edentulous patients 5 years after implant placement . MATERIAL S AND METHODS Fifty-two patients were r and omised in five Italian private practice s : 25 in the immediately loaded group and 27 in the early loaded group . To be immediately loaded , single implants had to be inserted with a torque of > 30 Ncm , and splinted implants with a torque of > 20 Ncm . Immediately loaded implants were provided with non-occluding temporary restorations within 48 hours . After 2 months , the provisional restorations were put in full occlusion . Implants were early loaded after 2 months . Final restorations were provided 8 months after implant placement . Outcome measures were prosthesis and implant failures as well as biological and prosthetic complications recorded by non-blinded assessors . Blinded assessors evaluated peri-implant bone and soft-tissue levels . RESULTS Fifty-two implants were immediately loaded and 52 early loaded . One patient of the early loaded group dropped out after the 1-year recall . One single immediately loaded implant failed 2 months after placement . Only one complication ( iatrogenic peri-implantitis ) occurred in one patient of the early loading group . Both groups gradually lost peri-implant bone in a highly statistically significant way at 2 , 8 and 14 months and at 4 and 5 years . After 5 years , patients of both groups had lost an average of 1.2 mm of peri-implant marginal bone . There were no statistically significant differences in peri-implant bone and soft-tissue level changes between the 2 groups . At 5 years , there was a statistically significant recession ( 0.2 mm ) of the vestibular soft tissues from baseline ( delivery of the final restorations 8 months after implant placement ) only for immediately loaded implants . CONCLUSIONS In well maintained patients , complications are uncommon and healthy and stable periimplant tissues can be maintained for 5 years around immediately and early loaded implants PURPOSE To evaluate the predictability of early and immediate loading protocol s of  implants in the posterior m and ible and to investigate whether there is a difference in success rates , survival rates , and peri-implant parameters , including marginal bone level changes , between loading protocol s. MATERIAL S AND METHODS A comprehensive systematic review of the literature was conducted . The selection of publications reporting on human clinical studies was based on predetermined inclusion criteria and was agreed upon by two review ers . RESULTS A total of 19 papers were selected : 8 on early loading , 9 addressing immediate loading , and 2 comparing immediate and early loading . Of the 19 studies , 5 were r and omized clinical trials and 14 were prospect i ve studies . CONCLUSIONS Existing literature supports the early loading of  microroughened dental implants in the partially edentulous posterior m and ible at 6 to 8 weeks in the absence of modifying factors . Therefore , loading within this time frame can be considered routine for the majority of clinical situations in the posterior m and ible , either with single crowns or fixed dental prostheses . Immediate loading of microroughened dental implants in the partially edentulous posterior m and ible proved to be a viable treatment alternative . Caution is necessary when interpreting published outcomes for immediate loading , as the inclusion exclusion criteria are inconsistent and many subjective confounding factors are evident . Additional studies with longer follow-ups , specifically r and omized clinical trials , are needed to consoli date the data for immediate loading . Priority should be given to trials testing immediate loading PURPOSE To evaluate early and immediate loading of implants in the posterior maxilla and to investigate whether there is a difference in success rates , survival rates , and peri-implant parameters , including marginal bone level changes . MATERIAL S AND METHODS A comprehensive systematic review of the literature was conducted . The selection of publications reporting on human clinical studies was based on predetermined inclusion criteria and was agreed upon by two review ers . RESULTS Twelve papers were identified on early loading ( two r and omized controlled clinical trials [ RCTs ] and 10 prospect i ve case series studies ) . Six papers were found on immediate loading ( one RCT , four prospect i ve case series , and one retrospective study ) . CONCLUSIONS Under certain circumstances it is possible to successfully load dental implants in the posterior maxilla early or immediately after their placement in selected patients . The success rate appears to be technique sensitive , although no study has directly assessed this . A high degree of primary implant stability ( high value of insertion torque ) and implant surface characteristics play an important role . It is not possible to draw evidence -based conclusions concerning 
    Output:
    
IL presents similar implant survival rates as EL or CL for partially edentulous patients with extended edentulous sites in the posterior zone , as long as strict inclusion /exclusion criteria are followed .
There is a lack of evidence for IL of multiple implants in the anterior zone of partially edentulous patients .
Preliminary evidence suggests that IL may be equally successful in either the maxilla or m and ible .