Raghoebar Gerry M, Friberg Bertil, Grunert Ingrid, Hobkirk John A, Tepper Gabor, Wendelhag Inger
Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthetics, University Hospital Groningen, The Netherlands.
Clin Implant Dent Relat Res. 2003;5(1):39-46. doi: 10.1111/j.1708-8208.2003.tb00180.x.
The long-term success rates achieved in dental implantology suggest that flexibility might well exist within the various implant systems to a degree that an altered protocol (ie, one-stage surgery and immediate or early loading) can be performed under controlled conditions. However, before variations of the protocol can be considered for general use, they must be subjected to critical analysis, particularly with respect to the predictability of osseointegration, alteration of soft tissue barrier, and relative change in bone height around the implants.
The aim of this prospective multicenter study was to evaluate implant survival and periimplant conditions around endosseous implants placed in a one-stage surgical procedure and early loading.
A total of 170 implants were placed in 40 patients with mandibular edentulism and were functionally loaded within 6 weeks with overdentures (n = 30) or fixed prostheses (n = 10). All patients and prosthetic constructions were evaluated according to a standardized protocol during 3 years of follow-up. Cumulative implant survival rates were calculated, and implant loss in relation to implant size and bone quality and quantity were evaluated. Furthermore, the protocol included assessment of clinical (plaque and bleeding scores, prosthesis stability) and radiographic parameters.
Over a period of 3 years, the implant survival rate was 93% for both implants and prostheses (fixed or removable). No implants were lost after the first year of loading. The periimplant tissues were in a healthy condition. Mean marginal bone resorption from the time of loading to the 3-year follow-up was 0.41 mm (SD 0.52).
From this study it may be concluded that early loading results in good implant survival and proper periimplant health in edentulous mandibles.
牙种植学所取得的长期成功率表明,各种种植系统在一定程度上可能具有灵活性,使得在可控条件下能够采用改变后的方案(即一期手术和即刻或早期负重)。然而,在考虑将方案的变化用于常规使用之前,必须对其进行严格分析,特别是在骨结合的可预测性、软组织屏障的改变以及种植体周围骨高度的相对变化方面。
这项前瞻性多中心研究的目的是评估在一期手术植入并早期负重的骨内种植体的种植体存留率和种植体周围状况。
共为40名下颌无牙患者植入170颗种植体,并在6周内用覆盖义齿(n = 30)或固定修复体(n = 10)进行功能负重。在3年的随访期间,所有患者和修复体结构均按照标准化方案进行评估。计算种植体累积存留率,并评估种植体丢失与种植体大小以及骨质量和骨量的关系。此外,该方案还包括对临床参数(菌斑和出血评分、修复体稳定性)和影像学参数的评估。
在3年期间,种植体和修复体(固定或可摘)的存留率均为93%。负重第一年后无种植体丢失。种植体周围组织状况健康。从负重时到3年随访时的平均边缘骨吸收为0.41 mm(标准差0.52)。
从本研究可以得出结论,早期负重可使无牙下颌的种植体获得良好的存留率和种植体周围健康状况。