Testori Tiziano, Del Fabbro Massimo, Szmukler-Moncler Serge, Francetti Luca, Weinstein Roberto L
University of Milan, Department of Odontology, Galeazzi Institute, Milan, Italy.
Int J Oral Maxillofac Implants. 2003 Jul-Aug;18(4):544-51.
This article reports the preliminary data from a clinical study of immediately loaded, full-arch, screw-retained prosthesis with distal extensions (hybrid prosthesis) supported by Osseotite implants placed in the edentulous mandible.
Fifteen patients who received 103 implants were enrolled in this study. The first 2 patients received both immediately loaded and submerged implants, while the remaining patients had all implants immediately loaded. The first 9 patients received a temporary prosthesis within 4 hours of surgery, and the hybrid prosthesis, made of a titanium framework and acrylic resin teeth, was placed after 6 months. The last 6 patients received the same type of hybrid prosthesis within 36 hours of surgery. Marginal bone loss was monitored via periapical radiographs by a computerized technique.
One failure (out of the 92 immediately loaded implants) occurred after 3 weeks of function because of infection. A cumulative success rate of 98.9% was achieved for up to 48 months of follow-up, while the prosthetic cumulative success rate for the same period was 100%. Marginal bone loss at the immediately loaded implants was within the generally accepted conventional limits for standard delayed loading protocols.
This technique can reduce treatment time but should be applied with caution.
The preliminary results of this study suggest that rehabilitation of the edentulous mandible by an immediately loaded hybrid prosthesis supported by 5 to 6 implants may represent a viable alternative treatment to the classical delayed loading protocols.
本文报告了一项临床研究的初步数据,该研究涉及在下颌无牙区植入Osseotite种植体支持的即刻负重、全牙弓、带有远中延伸部的螺丝固位假体(混合假体)。
15名患者共植入103枚种植体,纳入本研究。前2名患者同时植入了即刻负重种植体和潜入式种植体,其余患者的所有种植体均为即刻负重。前9名患者在术后4小时内佩戴临时假体,6个月后植入由钛框架和丙烯酸树脂牙制成的混合假体。最后6名患者在术后36小时内植入相同类型的混合假体。通过根尖片采用计算机技术监测边缘骨丢失情况。
92枚即刻负重种植体中有1枚在功能行使3周后因感染失败。随访长达48个月时,累积成功率达98.9%,同期修复体累积成功率为100%。即刻负重种植体的边缘骨丢失在标准延迟负重方案普遍接受的传统限度内。
该技术可缩短治疗时间,但应用时应谨慎。
本研究的初步结果表明,采用由5至6枚种植体支持的即刻负重混合假体修复下颌无牙区,可能是经典延迟负重方案的一种可行替代治疗方法。