Krennmair Gerald, Weinländer Michael, Schmidinger Stefan
Dental School, University of Vienna, Austria.
Int J Oral Maxillofac Implants. 2003 Jul-Aug;18(4):582-8.
The behavior of provisional implants in edentulous maxillae/mandibles used for anchoring removable interim overdentures was followed for the time of the intended healing of the definitive implants.
Twenty-eight edentulous arches (19 maxillae, 9 mandibles) were provided with 77 provisional implants (2 to 4 in maxillae; 2 or 3 in mandibles) for anchoring removable interim prostheses (overdentures). The provisional implants were to be maintained until final restoration (6 to 9 months in the maxilla and 3 months in the mandible). The loss rate of provisional implants and handling and behavior of the anchored overdenture were monitored until the definitive prosthetic restoration was placed.
Twenty-three (29.8%) of the 77 provisional implants were lost prematurely. The loss rate of maxillary provisional implants (21/58; 36.2%) was significantly higher than that of mandibular implants (2/19; 10.5%) (P < .01). Determination of terminal stability (by means of the Periotest) of the provisional implants showed higher stability in the mandible (+3.8 +/- 2.3) than in the maxilla (+8.6 +/- 3.9) (P < .05). In obvious contrast to mandibular interim overdentures, handling of maxillary interim overdentures was found to improve significantly during the follow-up period (P < .01).
With both the low loss rate in the mandible and the higher loss rate seen in the maxilla, placement of provisional implants fulfills the requirements for initiating immediate prosthetic rehabilitation. The removable interim overdenture can be adequately stabilized and provides for added patient comfort and satisfaction as compared to a conventional complete denture. An important aspect of the continued use of provisional implants concerns the expectations placed in these implants by both clinician and patient, which are quite different than those for definitive implants.
观察用于固定可摘式临时覆盖义齿的上颌/下颌无牙颌临时种植体在最终种植体预期愈合期内的情况。
为28个无牙牙弓(19个上颌,9个下颌)植入77颗临时种植体(上颌2至4颗;下颌2或3颗)以固定可摘式临时修复体(覆盖义齿)。临时种植体需保留至最终修复(上颌6至9个月,下颌3个月)。监测临时种植体的丢失率以及固定覆盖义齿的操作和情况,直至放置最终修复体。
77颗临时种植体中有23颗(29.8%)过早丢失。上颌临时种植体的丢失率(21/58;36.2%)显著高于下颌种植体(2/19;10.5%)(P <.01)。对临时种植体的最终稳定性(通过Periotest测定)显示,下颌种植体(+3.8±2.3)的稳定性高于上颌(+8.6±3.9)(P <.05)。与下颌临时覆盖义齿明显不同的是,上颌临时覆盖义齿在随访期间的操作有显著改善(P <.01)。
鉴于下颌较低的丢失率和上颌较高的丢失率,临时种植体的植入满足了即刻进行修复性康复的要求。与传统全口义齿相比,可摘式临时覆盖义齿能得到充分稳定,增加患者舒适度和满意度。持续使用临时种植体的一个重要方面涉及临床医生和患者对这些种植体的期望,这与对最终种植体的期望有很大不同。