Tawil Georges, Aboujaoude Nadim, Younan Roland
Department of Periodontology, St Joseph University, Beirut, Lebanon.
Int J Oral Maxillofac Implants. 2006 Mar-Apr;21(2):275-82.
Implants shorter than 10 mm can be a long-term solution for sites with limited bone height. The purpose of this study was to determine the influence of some prosthetic factors on the survival and complication rates.
Two hundred sixty-two short machined-surface Brånemark System implants were consecutively placed in 109 patients and followed for a mean of 53 months. The prosthetic parameters were recorded, and the data were examined for relation to peri-implant bone loss and biologic or biomechanical complications.
Relatively few crown-to-implant (C/I) ratios were < 1 or > 2 (16.2%). Occlusal table (OT) width ranged from 5.4 to 8.3 mm. Opposing dentition was most often natural teeth, a fixed prosthesis supported by natural teeth, or an implant-supported fixed restoration. Occlusion with a normal buccolingual maxillomandibular relationship was found in 72.7% of the cases. No significant difference in peri-implant bone loss was correlated with C/I ratio or OT. Neither cantilever length nor bruxism had a significant effect on peri-implant bone loss. Mean bone loss was 0.74 +/- .65 mm. The difference in the complication rate (15% overall) between the bruxer and the nonbruxer group was not statistically significant (P = .51). One implant was lost in a heavy bruxer after 7 years of function.
Increased C/I and OT values do not seem to be a major risk factor in cases of favorable loading. In 67% of the cases, the mesiodistal length of the prosthesis was less than the corresponding natural tooth length, which may have contributed to better load distribution and more favorable results.
Short implants appear to be a longterm viable solution in sites with reduced bone height, even when the prosthetic parameters exceed the normal values, provided that force orientation and load distribution are favorable and parafunction is controlled.
长度小于10毫米的种植体对于骨高度有限的部位可能是一种长期解决方案。本研究的目的是确定一些修复因素对种植体存活率和并发症发生率的影响。
将262颗短机械加工表面的布伦马克系统种植体连续植入109例患者体内,平均随访53个月。记录修复参数,并检查数据与种植体周围骨丢失以及生物学或生物力学并发症的关系。
相对较少的冠根比(C/I)小于1或大于2(16.2%)。咬合面(OT)宽度在5.4至8.3毫米之间。对颌牙列最常见的是天然牙、天然牙支持的固定修复体或种植体支持的固定修复体。72.7%的病例存在正常颊舌向上下颌关系的咬合。种植体周围骨丢失与C/I比或OT之间无显著差异。悬臂长度和磨牙症对种植体周围骨丢失均无显著影响。平均骨丢失为0.74±0.65毫米。磨牙症患者组与非磨牙症患者组之间的并发症发生率差异(总体为15%)无统计学意义(P = 0.51)。一颗种植体在重度磨牙症患者使用7年后丢失。
在负荷良好的情况下,C/I和OT值增加似乎不是主要危险因素。在67%的病例中,修复体的近远中长度小于相应天然牙的长度,这可能有助于更好的负荷分布和更有利的结果。
短种植体似乎是骨高度降低部位的一种长期可行解决方案,即使修复参数超过正常值,前提是力的方向和负荷分布良好且副功能得到控制。