Chow James, Hui Edward, Lee Philip K M, Li William
Oral and Maxillofacial Surgery, Associated Brånemark Osseointegration Center, Hong Kong SAR, China.
J Oral Maxillofac Surg. 2006 May;64(5):804-11. doi: 10.1016/j.joms.2006.01.021.
To investigate the modified protocol for immediate occlusal loading of the zygomatic implants and to report the preliminary results of this modified protocol.
Four male patients and 1 female patient with edentulous maxillae were consecutively treated with the zygomatic implants under general anesthesia. All 5 patients were examined by computed tomography and investigated by the SimPlant software (Materialise NV, Leuven, Belgium). Based on the virtual surgical plans, mucosa-supported surgical guides were manufactured by rapid prototyping technique before implant operation. Instead of making a Le Fort I Osteotomy incision or a crestal incision, buccal vestibular incision was used to expose the surgical site for the zygomatic implant osteotomy and placement. Three patients had their remaining upper teeth removed on the same day as implant placement. One patient had undergone simultaneous placement of upper and lower implants followed by immediate loading. The immediate loading protocol was a 2-stage method using a customized provisional fixed prosthesis.
Ten zygomatic implants and 20 normal implants were installed in these 5 patients. These 5 patients were reviewed regularly for 6 to 10 months after immediate loading. The zygomatic implants were considered to be successful when they were asymptomatic with no clinical mobility and no sign of infection. All the zygomatic implants and normal implants were investigated individually after removing the provisional prosthesis and were found to be clinically stable and asymptomatic.
According to our observation, immediate occlusal loading of the zygomatic implants has a very good potential for success, as much as immediate occlusal loading of normal dental implants. The surgical placement of the zygomatic implant is simplified and facilitated by making use of the computer-assisted planning and the rapid-prototyping surgical guides.
研究颧骨种植体即刻咬合加载的改良方案，并报告该改良方案的初步结果。
对4例男性患者和1例女性上颌无牙患者在全身麻醉下连续进行颧骨种植体治疗。所有5例患者均接受计算机断层扫描检查，并使用SimPlant软件（Materialise NV，比利时鲁汶）进行分析。根据虚拟手术计划，在种植手术前通过快速成型技术制作黏膜支持的手术导板。采用颊侧前庭切口暴露颧骨种植体截骨和植入部位，而不是采用Le Fort I截骨切口或嵴顶切口。3例患者在种植体植入当天拔除了剩余的上颌牙齿。1例患者同时植入了上下颌种植体，随后即刻加载。即刻加载方案采用两阶段方法，使用定制的临时固定修复体。
这5例患者共植入10枚颧骨种植体和20枚常规种植体。即刻加载后对这5例患者进行了6至10个月的定期复查。当颧骨种植体无症状、无临床松动且无感染迹象时，认为种植成功。拆除临时修复体后，对所有颧骨种植体和常规种植体进行单独检查，发现它们在临床上均稳定且无症状。
根据我们的观察，颧骨种植体即刻咬合加载与常规牙种植体即刻咬合加载一样，具有非常好的成功潜力。利用计算机辅助规划和快速成型手术导板简化并方便了颧骨种植体的手术植入。
