Complications, risk factors, and failures of immediate functional loading of implants placed in the completely edentulous maxillae: a report of 3 consecutive cases

The aim of this article was to document the failure of immediate functional loading of implants placed in 3 consecutive completely edentulous maxillae to analyze the possible causes, risk factors, and how to avoid the complications that occur due to this procedure. Six implants with standardized length and diameter were placed in 3 consecutive patients with completely edentulous maxillae in the canine, premolar, and molar region bilaterally and flaplessly using computer-guided surgical guides. Screw-retained conversion maxillary prostheses were delivered immediately after the surgery. Patients complained from severe to moderate pain. For the first and second patients (P1 and P2), 4 implants per patient were lost during the second week after implant surgery, whereas 5 implants were lost during the third week after implant surgery for the third patient (P3). This high failure rate presented in this report may be explained by 1 or more of the following reasons: poor maxillary bone quality, nonaxial loading of the implants, nonrigid splinting material, high forces delivered from the opposing dentition, and/or patients with para-functional habits.