Wright Robert F, Zemnick Candice, Wazen Jack J, Asher Eric
Advanced Graduate Prosthodontics, Harvard School of Dental Medicine, Boston, MA 02115, USA.
J Prosthodont. 2008 Aug;17(6):468-75. doi: 10.1111/j.1532-849X.2008.00309.x. Epub 2008 Jun 9.
The objective of this study was to report on the survival rate of 16 patients treated with extraoral implants in the auricular region, analyze treatment outcomes, and discuss important clinical variables encountered during treatment.
Sixteen patients who received extraoral dental implants to retain auricular prostheses between 1987 and 2003 were followed retrospectively. The variables recorded were gender, initial diagnosis, number and size of implants, implant placement date, age at implant placement, history of radiation to the treated field, abutment size, design of initial prosthesis, age of initial prosthesis (when a remake was indicated), date of prosthesis delivery, soft tissue response, grafting procedure, date of last follow-up, and complications. All patients were thoroughly evaluated presurgically by the reconstruction team, which consisted of prosthodontists, a facial prosthetist, and an otolaryngologist. Surgical templates were used for all patients. The criteria for success of the prostheses included marginal accuracy, overall stability and function, symmetry/position, texture, color stability, and patient acceptance.
Thirty-nine implants were placed in 16 patients. All 16 patients were completely satisfied with their reconstructions. No surgical complications, implant failures, or prosthetic failures were encountered. Therefore, the survival rate was 100%. Three patients (18.75%) had grade 0, seven (43.75%) had grade 1, five (31.25%) had grade 2, and one (6.25%) had grade 3 soft tissue inflammation. The inflammation completely resolved in 7 of the 13 patients (54%) with hygiene reinforcement or soft tissue reduction.
The survival rate for bone-anchored titanium implants and prostheses was 100%. Bone-anchored titanium implants provided the 16 patients in this study with a safe, reliable, adhesive-free method to anchor auricular prostheses with recovery of normal appearance. Under the guidance of an appropriate implant team, proper positioning of implants was optimized to allow prosthodontic rehabilitation using implant-retained prostheses.
本研究的目的是报告16例接受耳周区域口外种植体治疗患者的生存率，分析治疗结果，并讨论治疗过程中遇到的重要临床变量。
对1987年至2003年间接受口外牙种植体以固定耳假体的16例患者进行回顾性随访。记录的变量包括性别、初始诊断、种植体的数量和尺寸、种植体植入日期、种植时的年龄、治疗区域的放疗史、基台尺寸、初始假体设计、初始假体的使用年限（需要重做时）、假体交付日期、软组织反应、植骨程序、最后随访日期以及并发症。所有患者在术前均由由修复医师、面部修复师和耳鼻喉科医生组成的重建团队进行全面评估。所有患者均使用手术模板。假体成功的标准包括边缘精度、整体稳定性和功能、对称性/位置、质地、颜色稳定性以及患者接受度。
16例患者共植入39枚种植体。所有16例患者对其重建效果均完全满意。未出现手术并发症、种植体失败或假体失败。因此，生存率为100%。3例患者（18.75%）软组织炎症为0级，7例（43.75%）为1级，5例（31.25%）为2级，1例（6.25%）为3级。13例有软组织炎症的患者中，7例（54%）经加强口腔卫生或软组织修整后炎症完全消退。
骨锚式钛种植体及假体的生存率为100%。骨锚式钛种植体为该研究中的16例患者提供了一种安全、可靠、无需粘结的方法来固定耳假体，恢复正常外观。在合适的种植团队指导下，优化种植体的正确定位，以便使用种植体支持的假体进行修复重建。
