Gapski Ricardo, Wang Hom-Lay, Mascarenhas Paulo, Lang Niklaus P
Department of Periodontics/Prevention/Geriatrics, School of Dentistry, University of Michigan, Ann Arbor, MI 48109-1078, USA.
Clin Oral Implants Res. 2003 Oct;14(5):515-27. doi: 10.1034/j.1600-0501.2003.00950.x.
Implant dentistry has become successful with the discovery of the biological properties of titanium. In the original protocol, studies have advocated a 2-stage surgical protocol for load-free and submerged healing to ensure predictable osseointegration. However, the discomfort, inconvenience, and anxiety associated with waiting period remains a challenge to both patients and clinicians. Hence, loading implant right after placement was attempted and has gained popularity among clinicians. Issues/questions related to this approach remain unanswered. Therefore, it is the purpose of this review article to (1). review and analyze critically the current available literature in the field of immediate implant loading and (2). discuss, based on scientific evidence, factors that may influence this treatment modality.
Literature published over the past 20 years was selected and reviewed. Findings from these studies were discussed and summarized in the tables. The advantages and disadvantages associated with immediate implant loading were analyzed. Factors that may influence the success of immediate implant loading, including patient selection, type of bone quality, required implant length, micro- and macrostructure of the implant, surgical skill, need for achieving primary stability/control of occlusal force, and prosthesis guidelines, were thoroughly reviewed and discussed.
Various studies have demonstrated the feasibility and predictability of this technique. However, most of these articles are based on retrospective data or uncontrolled cases. Randomized, prospective, parallel-armed longitudinal human trials are primarily based on short-term results and long-term follow-ups are still scarce in this field. Nonetheless, from available literature, it may be concluded that anatomic locations, implant designs, and restricted prosthetic guidelines are key to ensure successful outcomes. Future studies, preferably randomized, prospective longitudinal studies, are certainly needed before this approach can be widely used.
随着钛生物特性的发现，种植牙技术取得了成功。在最初的方案中，研究提倡采用两阶段手术方案，进行无负载和埋入式愈合，以确保可预测的骨整合。然而，与等待期相关的不适、不便和焦虑对患者和临床医生来说仍然是一个挑战。因此，人们尝试在种植体植入后立即加载，并在临床医生中越来越受欢迎。与这种方法相关的问题仍未得到解答。因此，本综述文章的目的是：（1）批判性地回顾和分析即刻种植体加载领域的现有文献；（2）基于科学证据，讨论可能影响这种治疗方式的因素。
选择并回顾了过去20年发表的文献。这些研究的结果在表格中进行了讨论和总结。分析了即刻种植体加载的优缺点。全面回顾和讨论了可能影响即刻种植体加载成功的因素，包括患者选择、骨质类型、所需种植体长度、种植体的微观和宏观结构、手术技巧、实现初始稳定性/控制咬合力的需求以及修复体指南。
各种研究已经证明了该技术的可行性和可预测性。然而，这些文章大多基于回顾性数据或非对照病例。随机、前瞻性、平行对照的纵向人体试验主要基于短期结果，该领域的长期随访仍然很少。尽管如此，从现有文献中可以得出结论，解剖位置、种植体设计和受限的修复体指南是确保成功结果的关键。在这种方法能够广泛应用之前，肯定需要进行未来的研究，最好是随机、前瞻性纵向研究。
