The Brånemark Clinic, Public Dental Health Service, Göteborg, Sweden.
Clin Implant Dent Relat Res. 2009 Dec;11(4):311-22. doi: 10.1111/j.1708-8208.2008.00119.x. Epub 2008 Sep 9.
Comparative long-term knowledge of different framework materials in the edentulous implant patient is not available for 15 years of follow-up.
To report and compare a 15-year retrospective data on implant-supported prostheses in the edentulous mandible provided with laser-welded titanium frameworks (test) and gold alloy frameworks (control).
Altogether, 155 patients were consecutively treated with abutment-level prostheses with two early generations of fixed laser-welded titanium frameworks (titanium group). Fifty-three selected patients with gold alloy castings formed the control group. Clinical and radiographic 15-year data were collected and compared for the groups.
All patients who were followed up for 15 years (n = 72) still had a fixed prosthesis in the mandible at the termination of the study. The 15-year original prosthesis cumulative survival rate (CSR) was 89.2 and 100% for titanium and control frameworks (p = .057), respectively (overall CSR 91.7%). The overall 15-year implant CSR was 98.7%. The average 15-year bone loss was 0.59 mm (SD 0.56) and 0.98 mm (SD 0.64) for the test and control groups (p = .027), respectively. Few (1.3%) implants had >3.1-mm accumulated bone loss after 15 years. The most common complications for titanium frameworks were resin or veneer fractures and soft tissue inflammation. Fractures of the titanium metal frame were observed in 15.5% of the patients. More patients had framework fractures in the earliest titanium group (Ti-1 group) compared to the gold alloy group (p = .034). Loose and fractured implant screw components were few (2.4%).
Predictable overall long-term results could be maintained with the present treatment modality. Fractures of the metal frames and remade prostheses were more common in the test group, and the gold alloy frameworks had a tendency to work better when compared with welded titanium frameworks during 15 years. However, on the average, more bone loss was observed for implants supporting gold alloy frameworks.
在长达 15 年的随访中，对于无牙颌种植患者使用不同框架材料的长期比较知识尚不可用。
报告并比较 15 年回顾性数据，即无牙颌下颌植入物用激光焊接钛框架（实验组）和金合金框架（对照组）支撑的种植体支持式修复体。
共有 155 例患者连续接受了基台水平修复体治疗，其中使用了两代早期固定激光焊接钛框架（钛组）。53 名选择的金合金铸造患者组成对照组。收集并比较了两组的临床和影像学 15 年数据。
所有随访 15 年（n=72）的患者在研究结束时仍在下颌保留固定修复体。钛组和对照组的 15 年原始修复体累计生存率（CSR）分别为 89.2%和 100%（p=0.057）（总体 CSR 为 91.7%）。总的 15 年种植体 CSR 为 98.7%。实验组和对照组的平均 15 年骨吸收量分别为 0.59mm（SD 0.56）和 0.98mm（SD 0.64）（p=0.027）。15 年后，仅有少数（1.3%）种植体发生>3.1mm的累积骨吸收。钛框架最常见的并发症是树脂或贴面断裂和软组织炎症。15.5%的患者出现钛金属框架断裂。在最早的钛组（Ti-1 组）中，框架断裂的患者多于金合金组（p=0.034）。松动和断裂的种植体螺钉组件很少（2.4%）。
采用目前的治疗方法可获得可预测的长期结果。实验组中金属框架和修复体的断裂更为常见，与激光焊接钛框架相比，金合金框架在 15 年内的工作效果更好。然而，总的来说，用金合金框架支撑的种植体观察到更多的骨丢失。
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