Stephan Gregory, Vidot Fabien, Noharet Renaud, Mariani Paul
Department of Prosthodontics, Gaston Berger Center for Care and Research in Dentistry, School of Dentistry, Marseille, France.
J Prosthet Dent. 2007 Jun;97(6 Suppl):S138-45. doi: 10.1016/S0022-3913(07)60017-1.
Treatment options for an increasing number of completely edentulous patients using fixed restorations may be limited due to anatomical or financial constraints.
The purpose of this pilot study was to compare immediate loading versus conventional delayed loading of implants placed for the retention of mandibular overdentures.
Twenty-six subjects each received 3 implants placed in the symphysis area which were connected with a gold bar. In the experimental group (n=17), the 3 splinted implants were loaded 2 days after surgery; in the control group (n=9), the 3 implants were loaded 3 months after surgery using a conventional 2-stage approach. Recall appointments were scheduled every 3 months during the 2-year follow-up. The following clinical parameters were included and assessed: health of periimplant soft tissues using the bleeding index (BI), plaque index (PI), periimplant probing depth (PIPD), periimplant bone resorption as measured on panoramic radiographs, and implant stability using resonance frequency analysis (RFA). The Mann-Whitney test (alpha=.05) was used to compare each parameter in the 2 groups.
After 2 years, no implant failure was recorded in either group. No significant difference was found between the 2 groups after 2 years with regard to BI (P=.33), PI (P=.81), PIPD (P=.61), periimplant bone resorption (P=.32), or RFA (P=.06). After 1 year, periimplant bone loss (P=.05) and PIPD (P=.005) were increased in the control group.
Immediate loading of 3 splinted implants retaining a mandibular overdenture shortens treatment time for prosthesis insertion and shows, after 2 years, results comparable with the delayed approach.
由于解剖学或经济限制，越来越多使用固定修复体的全口无牙患者的治疗选择可能有限。
本初步研究的目的是比较为下颌覆盖义齿固位而植入种植体的即刻负重与传统延迟负重。
26名受试者每人在颏联合区植入3颗种植体，并用一根金条连接。实验组（n = 17），3颗夹板式种植体在术后2天进行负重；对照组（n = 9），3颗种植体采用传统的两阶段方法在术后3个月进行负重。在2年的随访期间，每3个月安排一次复诊。纳入并评估以下临床参数：使用出血指数（BI）、菌斑指数（PI）评估种植体周围软组织健康状况，种植体周围探诊深度（PIPD），通过全景X线片测量种植体周围骨吸收情况，以及使用共振频率分析（RFA）评估种植体稳定性。采用Mann-Whitney检验（α = 0.05）比较两组的各项参数。
2年后，两组均未记录到种植体失败。2年后，两组在BI（P = 0.33）、PI（P = 0.81）、PIPD（P = 0.61）、种植体周围骨吸收（P = 0.32）或RFA（P = 0.06）方面均未发现显著差异。1年后，对照组的种植体周围骨丢失（P = 0.05）和PIPD（P = 0.005）增加。
用于下颌覆盖义齿固位的3颗夹板式种植体即刻负重可缩短义齿植入的治疗时间，并且2年后的结果与延迟负重方法相当。
