上颌前部即刻修复的单锥度种植体:1年后的修复和美学效果
Immediately restored, single-tapered implants in the anterior maxilla: prosthodontic and aesthetic outcomes after 1 year.
作者信息
Hall James A G, Payne Alan G T, Purton David G, Torr Brendan, Duncan Warwick J, De Silva Rohana Kumara
机构信息
Oral Implantology Area of Research Strength, Department of Oral Rehabilitation, School of Dentistry, University of Otago, Dunedin, New Zealand.
出版信息
Clin Implant Dent Relat Res. 2007 Mar;9(1):34-45. doi: 10.1111/j.1708-8208.2007.00029.x.
BACKGROUND
Conventional implant protocols advocate a two-stage technique with a load-free, submerged healing period. Recent studies suggest that immediate restoration of single implants may be a viable treatment option.
PURPOSE
The purpose of this study was to evaluate prosthodontic and aesthetic peri-implant mucosal outcomes of immediately restored, Southern single-tapered implants in the anterior maxilla after 1 year.
MATERIALS AND METHODS
Participants (mean age: 43.25 years; range: 23-71 years) satisfying specified inclusion criteria were randomly allocated to conventional two-stage restoration (control group; n=14) and immediate restoration groups (test group; n =14) in a randomized controlled clinical trial. Tapered, roughened-surface Southern implants were placed using a standardized technique, and implant level bone impressions were made. Provisional screw-retained crowns, out of occlusion, were placed at second-stage surgery after 26 weeks for the conventional restoration group, and within 4 hours of implant placement for the immediate restoration group. Both groups had definitive screw-retained metal-ceramic crowns placed in occlusion 8 weeks later. Peri-implant mucosal response and papilla index were recorded 4 weeks after definitive crown placement to allow for mucosal maturation and at 1 year. Prosthodontic and aesthetic outcomes were assessed using established criteria.
RESULTS
There were no significant differences within, or between, the control and test groups for age, gender, bone quality or quantity, implant stability measurements at surgery, or implant length. There were no significant differences in the implant success rate as determined by radiographic bone loss and stability tests after 1 year. There were no significant differences in prosthodontic maintenance, peri-implant mucosal response, and papilla index between the two groups over 1 year.
CONCLUSIONS
Tapered, roughened-surface implants immediately restored with single provisional crowns at surgery and definitive crowns 8 weeks later were as prosthodontically and aesthetically successful as conventionally restored two-stage implants during the first year of service. Restoring single implants immediately with screw-retained crowns is an efficient procedure, but the short-term outcome is by no means superior to a conventional two-stage approach.
背景
传统种植方案主张采用两阶段技术,即无负载的潜入式愈合期。近期研究表明,单颗种植体的即刻修复可能是一种可行的治疗选择。
目的
本研究旨在评估上颌前部即刻修复的南方单锥度种植体在1年后的修复及美学种植体周围黏膜结局。
材料与方法
在一项随机对照临床试验中,将符合特定纳入标准的参与者(平均年龄:43.25岁;范围:23 - 71岁)随机分配至传统两阶段修复组(对照组;n = 14)和即刻修复组(试验组;n = 14)。采用标准化技术植入锥形、表面粗糙的南方种植体,并制取种植体水平的骨印模。传统修复组在26周后的二期手术时放置临时螺丝固位冠,使其脱离咬合,即刻修复组在种植体植入后4小时内放置。两组均在8周后放置最终的螺丝固位金属烤瓷冠。在最终冠放置4周后(以实现黏膜成熟)及1年后记录种植体周围黏膜反应和乳头指数。采用既定标准评估修复和美学结局。
结果
对照组和试验组在年龄、性别、骨质量或骨量、手术时的种植体稳定性测量值或种植体长方面,组内及组间均无显著差异。1年后通过影像学骨吸收和稳定性测试确定的种植体成功率无显著差异。两组在1年期间的修复维护、种植体周围黏膜反应和乳头指数方面均无显著差异。
结论
锥形、表面粗糙的种植体在手术时即刻用单临时冠修复,8周后用最终冠修复,在服务的第一年,其修复和美学效果与传统两阶段修复种植体一样成功。用螺丝固位冠即刻修复单颗种植体是一种有效的方法,但短期效果绝非优于传统两阶段方法。