Department Prosthetic Dentistry/Dental Materials Science, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Sweden.
Clin Implant Dent Relat Res. 2012 Mar;14(1):88-99. doi: 10.1111/j.1708-8208.2009.00232.x. Epub 2009 Aug 17.
No long-term clinical studies covering more than 5 years are available on Computer Numeric Controlled (CNC) milled titanium frameworks.
To evaluate and compare the clinical and radiographic performance of implant-supported prostheses provided with CNC titanium frameworks in the edentulous jaw with prostheses with cast gold-alloy frameworks during the first 10 years of function.
Altogether, 126 edentulous patients were by random provided with 67 prostheses with titanium frameworks (test) in 23 maxillas and 44 mandibles, and with 62 prostheses with gold-alloy castings (control) in 31 maxillas and 31 mandibles. Clinical and radiographic 10-year data were collected for the groups and statistically compared on patient level.
The 10-year prosthesis and implant cumulative survival rate was 95.6% compared with 98.3%, and 95.0% compared with 97.9% for test and control groups, respectively (p > .05). No implants were lost after 5 years of follow-up. Smokers lost more implants than nonsmokers after 5 years of follow-up (p < .01). Mean marginal bone loss in the test group was 0.7 mm (SD 0.61) and 0.7 mm (SD 0.85) in the maxilla and mandible, with similar pattern in the control group (p > .05), respectively. One prosthesis was lost in each group due to loss of implants, and one prosthesis failed due to framework fracture in the test group. Two metal fractures were registered in each group. More appointments of maintenance were needed for the prostheses in the maxilla compared with those in the mandible (p < .001).
The frequency of complications was low with similar clinical and radiological performance for both groups during 10 years. CNC-milled titanium frameworks are a viable alternative to gold-alloy castings for restoring patients with implant-supported prostheses in the edentulous jaw.
目前尚无涵盖 5 年以上的计算机数控（CNC）铣削钛框架的长期临床研究。
评估和比较在无牙颌中使用 CNC 钛框架和铸造金合金框架制作的种植体支持修复体在最初 10 年的功能期间的临床和影像学性能。
共有 126 名无牙颌患者随机分为两组，其中 67 名患者使用钛框架修复体（实验组），分别植入 23 个上颌和 44 个下颌，62 名患者使用金合金铸造修复体（对照组），分别植入 31 个上颌和 31 个下颌。收集两组患者的 10 年临床和影像学数据，并进行患者水平的统计学比较。
实验组和对照组的 10 年修复体和种植体累积存活率分别为 95.6%和 98.3%，95.0%和 97.9%（p>0.05）。随访 5 年后无种植体丢失。随访 5 年后，吸烟者的种植体丢失率高于非吸烟者（p<0.01）。实验组上颌和下颌的平均边缘骨吸收量分别为 0.7mm（SD 0.61）和 0.7mm（SD 0.85），对照组的模式相似（p>0.05）。实验组和对照组各有 1 个修复体因种植体脱落而丢失，1 个修复体因框架骨折而失败。两组各有 2 例金属骨折。上颌修复体需要更多的维护预约，而下颌修复体则较少（p<0.001）。
两组在 10 年内的并发症发生率较低，临床和影像学表现相似。对于无牙颌患者的种植体支持修复体，CNC 铣削钛框架是金合金铸造的一种可行替代方案。
