Aparicio Carlos, Ouazzani Wafaa, Garcia Roberto, Arevalo Xabier, Muela Rosa, Fortes Vanessa
Department of Biomaterials, Institute for Surgical Sciences, Sahlgrenska Academy, Göteberg University, Göteberg, Sweden.
Clin Implant Dent Relat Res. 2006;8(3):114-22. doi: 10.1111/j.1708-8208.2006.00009.x.
Prosthetic rehabilitation with implant-supported prostheses in the atrophic edentulous maxilla often requires a bone augmentation procedure to enable implant placement and integration. However, a rigid anchorage can also be achieved by using so-called zygomatic implants placed in the zygomatic arch in combination with regular implants placed in residual bone.
The aim of the present study was to report on the clinical outcome of using zygomatic and regular implants for prosthetic rehabilitation of the severely atrophic edentulous maxilla.
Sixty-nine consecutive patients with severe maxillary atrophy were, during a 5-year period, treated with a total of 69 fixed full-arch prostheses anchored on 435 implants. Of these, 131 were zygomatic implants and 304 were regular implants. Fifty-seven bridges were screw-retained and 12 were cemented. The screw-retained bridges were removed at the examination appointments and each implant was tested for mobility. In addition, the zygomatic implants were subjected to Periotest (Siemens AG, Bensheim, Germany) measurements. The patients had at the time of this report been followed for at least 6 months up to 5 years in loading.
Two regular implants failed during the study period giving a cumulative survival rate of 99.0%. None of the zygomatic implants was removed. All patients received and maintained a fixed full-arch bridge during the study. Periotest measurements of zygomatic implants showed a decreased Periotest values value with time, indicating an increased stability. Three patients presented with sinusitis 14-27 months postoperatively, which could be resolved with antibiotics. Loosening of the zygomatic implant gold screws was recorded in nine patients. Fracture of one gold screw as well as the prosthesis occurred twice in one patient. Fracture of anterior prosthetic teeth was experienced in four patients.
The results from the present study show that the use of zygomatic and regular implants represents a predictable alternative to bone grafting in the rehabilitation of the atrophic edentulous maxilla.
在萎缩性无牙上颌骨中使用种植体支持的修复体进行修复重建通常需要进行骨增量手术，以实现种植体的植入和整合。然而，通过在颧弓植入所谓的颧骨种植体并结合在剩余骨中植入常规种植体，也可以实现稳固的固位。
本研究的目的是报告使用颧骨种植体和常规种植体对严重萎缩性无牙上颌骨进行修复重建的临床结果。
在5年期间，连续69例严重上颌骨萎缩患者接受了总共69个固定全牙弓修复体的治疗，这些修复体由435枚种植体支持。其中，131枚为颧骨种植体，304枚为常规种植体。57个桥体采用螺丝固位，12个采用粘结固位。在检查时拆除螺丝固位的桥体，并对每个种植体进行松动度测试。此外，对颧骨种植体进行Periotest（德国西门子公司，本斯海姆）测量。在撰写本报告时，患者的随访时间为至少6个月至负重5年。
在研究期间，有2枚常规种植体失败，累积存留率为99.0%。没有一枚颧骨种植体被取出。在研究期间，所有患者都接受并保留了一个固定全牙弓桥体。对颧骨种植体的Periotest测量显示，随着时间的推移，Periotest值降低，表明稳定性增加。3例患者在术后14 - 27个月出现鼻窦炎，使用抗生素后得以解决。记录到9例患者的颧骨种植体金螺丝松动。1例患者发生1枚金螺丝和修复体断裂2次。4例患者出现前牙修复体折断。
本研究结果表明，在萎缩性无牙上颌骨的修复中，使用颧骨种植体和常规种植体是一种可预测的替代骨移植的方法。
