Alfadda Sara A, Attard Nikolai J, David Lesley A
Department of Prosthodontics, Faculty of Dentistry, University of Toronto, Ontario, Canada.
Int J Prosthodont. 2009 Jul-Aug;22(4):368-73.
The aim of this report is to present the clinical and patient-based outcomes of an immediate-loading protocol of TiUnite implants with mandibular overdentures in edentulous patients 5 years following initial placement.
The study comprised two groups of edentulous patients. In the experimental group, 35 consecutively treated patients received 70 TiUnite implants that were loaded immediately, as well as 69 Branemark machined implants as a backup treatment. One patient received one Branemark implant. The control group comprised patients who were treated previously with conventional two-stage implant procedures, but were all case matched to the intervention group and served as a historical cohort. This group included 42 patients who received 111 Branemark implants. Both groups of patients were treated with overdentures that were supported with a standardized resilient bar mechanism. Clinical and patient-based outcomes in the immediate group were recorded for the first 5 years following the initial placement of implants and were measured at various stages of treatment using two questionnaires: the Denture Satisfaction Scale and the Oral Health Impact Profile (OHIP-20).
Just over 98% of implants were found to be successful in both groups (Fisher exact test: P = 1.000). A statistically significant improvement in patients' total, mandibular, and functional satisfaction scores was found when comparing baseline data to the data obtained 5 years following loading in the experimental group (P < .001). There were no significant differences between the 1- and 5-year total, mandibular, and functional satisfaction scores, or between baseline and 5-year maxillary denture satisfaction scores. A statistically significant and positive correlation was found between baseline and 1-year maxillary satisfaction scores (P = .002). Any improvement in the patients' quality of life (QoL) was maintained during the first 5 years of loading.
The results of this longitudinal study suggest that immediate loading of two dental implants by means of bar-retained mandibular overdentures is a predictable treatment option and leads to substantial improvement in patients' satisfaction and QoL. Importantly, this mirrors the outcomes found for patients subjected to the more commonly accepted two-stage implant procedure.
本报告旨在呈现无牙颌患者在最初植入TiUnite种植体并使用下颌覆盖义齿进行即刻负重方案5年后的临床及基于患者的治疗结果。
本研究包括两组无牙颌患者。实验组中，35例连续接受治疗的患者植入了70颗即刻负重的TiUnite种植体，另有69颗Branemark机械加工种植体作为备用治疗方案。1例患者植入了1颗Branemark种植体。对照组包括先前接受传统两阶段种植手术治疗的患者，但所有病例均与干预组进行匹配，作为历史队列。该组包括42例患者，植入了111颗Branemark种植体。两组患者均采用标准化弹性杆机制支持的覆盖义齿进行治疗。在种植体最初植入后的前5年记录即刻负重组的临床及基于患者的治疗结果，并在治疗的各个阶段使用两份问卷进行测量：义齿满意度量表和口腔健康影响程度量表（OHIP-20）。
两组中均发现超过98%的种植体成功（Fisher精确检验：P = 1.000）。将实验组的基线数据与负重5年后获得的数据进行比较时，患者的总体、下颌和功能满意度得分有统计学意义的显著改善（P <.001）。1年和5年的总体、下颌和功能满意度得分之间，以及基线和5年的上颌义齿满意度得分之间均无显著差异。基线和1年的上颌满意度得分之间存在统计学意义的正相关（P =.002）。在负重的前5年中，患者的生活质量（QoL）的任何改善均得以维持。
这项纵向研究的结果表明，通过杆式固位下颌覆盖义齿对两颗牙种植体进行即刻负重是一种可预测的治疗选择，可显著提高患者的满意度和生活质量。重要的是，这与接受更普遍认可的两阶段种植手术的患者的治疗结果相似。
