Ostman Pär-Olov, Hellman Mats, Sennerby Lars
Department of Biomaterials, Institute for Surgical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
Int J Oral Maxillofac Implants. 2008 Mar-Apr;23(2):315-22.
The purpose of the present prospective clinical study was to evaluate the radiographic and clinical outcome of immediately loaded implants in the partial edentulous mandible over a 4-year follow-up period using a modified surgical protocol, primary implant stability criteria, and splinting for inclusion.
Patients in need of implant treatment in the partial edentate mandible were consecutively included in the study. The implant sites were underprepared to obtain maximal stability. Inclusion criteria for the study were torque of a least 30 Ncm before final seating of the implant and an ISQ greater than 60. A provisional fixed partial denture was delivered within 24 hours and a definitive fixed partial denture within 3 months. The patients were monitored with clinical and radiographic follow-up examinations for up to 4 years. Stability of the implants was measured with resonance frequency analysis at placement and after 6 months.
Ninety-six patients were evaluated, and 77 patients who met the inclusion criteria were included. A total of 111 fixed partial dentures supported by 257 Brånemark System implants (77 turned and 180 TiUnite implants) were delivered. Four (1.6%) of the 257 implants did not osseointegrate, giving an overall survival rate of 98.4% after 4 years. Three turned (3.9%) implants and 1 oxidized implant (0.6%) failed after 4 to 13 months. The average marginal bone resorption was 0.7 mm (SD 0.78) during the first year in function. Turned implants showed an average bone loss of 0.5 mm (SD 0.8) and oxidized implants an average of 0.7 mm (SD 0.8). Resonance frequency analysis showed a mean implant stability quotient of 72.2 (SD 7.5) at placement and 72.5 (SD 5.7) after 6 months of loading.
It is concluded that immediate loading of implants with firm primary stability in partially edentulous areas of the mandible appears to be a viable procedure with predictable outcome.
本前瞻性临床研究的目的是使用改良的手术方案、种植体初始稳定性标准和夹板固定纳入标准，在4年的随访期内评估部分无牙下颌骨即刻负重种植体的影像学和临床结果。
需要在下颌部分无牙区进行种植治疗的患者连续纳入本研究。种植部位准备不足以获得最大稳定性。本研究的纳入标准为种植体最终就位前扭矩至少为30 Ncm且种植体稳定性商数（ISQ）大于60。在24小时内戴入临时固定局部义齿，3个月内戴入最终固定局部义齿。对患者进行临床和影像学随访检查，最长4年。在种植体植入时和6个月后用共振频率分析测量种植体的稳定性。
评估了96例患者，77例符合纳入标准的患者被纳入。共戴入了由257枚Brånemark系统种植体（77枚机加工表面种植体和180枚TiUnite种植体）支持的111副固定局部义齿。257枚种植体中有4枚（1.6%）未发生骨结合，4年后总体生存率为98.4%。3枚机加工表面种植体（3.9%）和1枚氧化锆种植体（0.6%）在4至13个月后失败。在功能的第一年，平均边缘骨吸收为0.7 mm（标准差0.78）。机加工表面种植体平均骨丢失0.5 mm（标准差0.8），氧化锆种植体平均骨丢失0.7 mm（标准差0.8）。共振频率分析显示，种植体植入时平均种植体稳定性商数为72.2（标准差7.5），负重6个月后为72.5（标准差5.7）。
得出结论，在下颌部分无牙区即刻负重具有稳固初始稳定性的种植体似乎是一种可行的方法，结果可预测。
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