Date of Graduation


Document Type


Degree Type



School of Dentistry



Committee Chair

Arif Salman

Committee Co-Chair

Gian Pietro Schincaglia

Committee Member

Gian Pietro Schincaglia

Committee Member

Fotinos Panagakos


The purpose of this study was to test the treatment concept of maxillary overdenture retained by four unsplinted implants placed using a flapless guided approach and immediate loading with Novaloc® attachments. Subjects with fully edentulous maxillae received 4 BLX implants (Roxolid®, SLActive®, 3.75mm diameter, Institut Straumann AG, Basel, Switzerland) to support an immediately loaded overdenture. Implants were connected with Novaloc® attachments (Institut Straumann AG, Basel, Switzerland) immediately following surgery if insertion torque (IT) reached 20 N/cm or above. The primary outcome variable was the radiographic bone level change at 6- and 12-months following implant placement. Secondary outcome variables were peri-implant soft tissue assessment (PD, KT, BoP, PI), implant stability quotient (ISQ), and implant survival throughout the study period. Ten patients with a mean age of 61.0 years (range: 27-80. SD=14.5) were enrolled in the study and 40 implants were placed. Thirty-eight and 35 implants were available for data analysis at 6 and 12 months. Radiographic bone level change averaged 0.16 ± 0.42 (p=0.017) and 0.33 ± 0.87 mm (p=0.013) at 6 and 12 months respectively. The implant survival rate was 95.0% as two implants failed. Within the limitations of this study, results indicate that this minimally invasive treatment approach may be a suitable treatment option for the edentulous maxilla.