Lekholm Ulf, Gröndahl Kerstin, Jemt Torsten
Department of Oral and Maxillofacial Surgery, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
Clin Implant Dent Relat Res. 2006;8(4):178-86. doi: 10.1111/j.1708-8208.2006.00019.x.
Most long-term follow-up studies of implants in partially edentulous jaws present their outcomes as mean values of implant survival and follow-up time, and few address the fate of the remaining teeth.
The aim of this study was to investigate the results of oral implant treatment in partially edentulous jaws after 20 years, and simultaneously to assess what happens to teeth present at the time of implant placement.
Seventeen partially edentulous patients, of 27 originally treated individuals, were retrospectively reviewed after receiving implants from 1983 to 1985. The parameters studied were implant survival, prosthesis stability, marginal bone loss at teeth and implants, treatment complications, need for dental treatment, and patient's satisfaction with the outcome.
The cumulative survival rate was 91%, when all 27 patients were assessed, that is, including the 10 dropouts. Of the 69 inserted and followed implants (Brånemark system; Nobel Biocare AB, Göteborg, Sweden), six failed (8.7%) during the 20-year period, four during the first decade, and the remaining two during the second. A majority (n=4) of the losses were due to implant fractures, two after 8 years, and two after 17 years. In all, 10 of the original fixed bridges being followed (n=24) remained in function during the entire investigation period, whereas 12 were exchanged for new constructions after an average of 7 years. The mean marginal bone loss at teeth was 0.7 mm, and at implants it was 1.0 mm. The major complication observed during the second decade was veneer material fractures, which occurred 14 times in six patients. Component loosening and abutment- and bridge-locking screw fractures were the second most common problems seen, indicating material/component fatigue. Most patients were satisfied with their treatment and many mentioned that they did not think of the constructions as anything but a part of their own body.
Over the decades, treatment of partially edentulous jaws with turned titanium implants seems to function well and to provide patients with good support for fixed short-span bridge constructions.
大多数关于部分牙列缺损颌骨种植体的长期随访研究将其结果呈现为种植体存留率和随访时间的平均值,很少涉及剩余牙齿的转归情况。
本研究旨在调查部分牙列缺损颌骨种植治疗20年后的结果,同时评估种植体植入时存在的牙齿的情况。
对1983年至1985年接受种植治疗的27例患者中的17例部分牙列缺损患者进行回顾性研究。研究参数包括种植体存留率、修复体稳定性、牙齿和种植体周围的边缘骨吸收、治疗并发症、牙科治疗需求以及患者对治疗结果的满意度。
当评估所有27例患者(包括10例失访患者)时,累积存留率为91%。在69枚植入并随访的种植体(Brånemark系统;诺贝尔生物保健公司,瑞典哥德堡)中,20年间有6枚失败(8.7%),其中4枚在第一个十年失败,其余2枚在第二个十年失败。大部分(n = 4)种植体失败是由于种植体折断,2枚在8年后折断,2枚在17年后折断。在整个研究期间,最初随访的24个固定桥中有10个仍在使用,而12个平均在7年后更换为新修复体。牙齿的平均边缘骨吸收为0.7mm,种植体为1.0mm。第二个十年观察到的主要并发症是贴面材料折断,6例患者共发生14次。部件松动以及基台和桥固位螺钉折断是第二常见的问题,提示材料/部件疲劳。大多数患者对治疗满意,许多患者提到他们认为这些修复体就是自己身体的一部分。
几十年来,使用机加工钛种植体治疗部分牙列缺损颌骨似乎效果良好,能为患者提供良好的固定短跨度桥修复支持。