Crespi Roberto, Capparé Paolo, Gherlone Enrico, Romanos George E
Department of Dentistry, "Vita Salute" University, San Raffaele Hospital, Via Olgettina N.48, 20132 Milano, Italy.
Int J Oral Maxillofac Implants. 2008 Jul-Aug;23(4):753-8.
The aim of this study was to report a clinical comparative assessment of crestal bone level change around single implants in fresh extraction sockets in the esthetic zone of the maxilla either immediately loaded or loaded after a delay.
Forty patients were included in a prospective, randomized study. All patients required 1 tooth extraction (ie, 1 tooth with a hopeless prognosis) and were randomized into either the test group or the control group. Implants were positioned immediately after tooth extraction and were loaded immediately in the test group (20 implants) and after 3 months in the control group (20 implants). The implant site was prepared, with at least 4 mm of sound apical bone below the implant apex, and the coronal margin of the implant was placed at the buccal level of the bone crest. All implants were 13 mm long; 30 implants had a diameter of 5 mm, and 10 had a diameter of 3.75 mm. Radiographic examinations were made at baseline, at 6 months, and at 24 months. To compare the mean values between test and control group, a paired t test was performed (considered statistically significant at P < .05).
After a 24-month follow-up period, a cumulative survival rate of 100% was reported for all implants. The control group resulted in a mean mesial bone loss of 1.16 +/- 0.32 mm and a mean distal bone loss of 1.17 +/- 0.41 (mean bone loss, 1.16 +/- 0.51 mm). The test group resulted in a mesial bone loss of 0.93 +/- 0.51 mm and a distal bone loss of 1.1 +/- 0.27 mm (mean bone loss, 1.02 +/- 0.53 mm). No statistically significant difference between control and test groups (P > .05) was found.
The success rate and radiographic results of immediate restorations of dental implants placed in fresh extraction sockets were comparable to those obtained in delayed loading group.
本研究旨在报告对上颌美学区新鲜拔牙窝内单颗种植体即刻负重或延期负重后嵴顶骨水平变化的临床比较评估。
40例患者纳入一项前瞻性随机研究。所有患者均需拔除1颗牙齿(即1颗预后无望的牙齿),并随机分为试验组或对照组。试验组(20颗种植体)在拔牙后即刻植入种植体并即刻负重,对照组(20颗种植体)在拔牙后3个月植入种植体并负重。制备种植体植入部位,使种植体根尖下方至少有4mm健康的根尖骨,种植体的冠方边缘置于牙槽嵴颊侧水平。所有种植体长13mm;30颗种植体直径为5mm,10颗种植体直径为3.75mm。在基线、6个月和24个月时进行影像学检查。为比较试验组和对照组的平均值,进行配对t检验(P <.05认为具有统计学意义)。
经过24个月的随访期,所有种植体的累积生存率均报告为100%。对照组的近中骨吸收平均值为1.16±0.32mm,远中骨吸收平均值为1.17±0.41(平均骨吸收,1.16±0.51mm)。试验组的近中骨吸收为0.93±0.51mm,远中骨吸收为1.1±0.27mm(平均骨吸收,1.02±0.53mm)。对照组和试验组之间未发现统计学显著差异(P>.05)。
新鲜拔牙窝内植入的牙种植体即刻修复的成功率和影像学结果与延期负重组相当。