Department of Periodontology and Oral Implantology, Dental School, University Ghent Belgium.
Clin Implant Dent Relat Res. 2011 Sep;13(3):175-83. doi: 10.1111/j.1708-8208.2009.00200.x. Epub 2009 Sep 9.
Flapless, free-handed implant surgery offers advantages for patient comfort, but studies on long-term clinical success based on marginal bone loss are scarce.
The aim of this study was to compare single implants installed with a flap (F) or flapless (FL) surgery with respect to survival and marginal bone preservation after at least 3 years.
Fifty-three TiUnite™ Brånemark implants, installed in 49 patients (27 females; 22 males; mean age 53 years) were examined. Then, 25 F and 28 FL were delayed loaded; bone level from the abutment-implant level was measured on intraoral radiographs. From 44 (21 F, 23 FL), 31 (18F, 13 FL), and 36 (18 F, 18 FL) implants, radiographs were available at baseline and after 1 and 3 years of function.
The overall survival rate was 100% and the overall mean bone loss after an average of 38 months was 1.35 mm (SD 0.91; range 0-3.7). Both F and FL showed increasing bone loss during the first year with a higher bone loss for FL than for F sites (p < .01). Afterward, no further bone loss occurred and both groups were statistically equal (p > .7). On individual implant level, nearly 80% in both F and FL were considered a success showing bone loss between 1.5 and 1.9 mm.
Single implants yield an excellent prognosis with stable bone levels irrespective of the surgical technique, and free-handed flapless surgery is a viable alternative to more extensively planned guided surgery. Proper case selection and clinical experience are considered prerequisites for a predictable treatment outcome.
无瓣、徒手种植手术可为患者提供舒适性优势，但基于边缘骨丧失的长期临床成功研究较为缺乏。
本研究旨在比较使用瓣（F）或无瓣（FL）手术植入的单个种植体在至少 3 年后的存活率和边缘骨保存情况。
共检查了 49 名患者（27 名女性；22 名男性；平均年龄 53 岁）的 53 个 TiUnite™ Brånemark 种植体。然后，25 个 F 和 28 个 FL 被延迟负载；从基台-种植体水平测量口内射线照片上的骨水平。从 44 个（21 个 F，23 个 FL）、31 个（18 个 F，13 个 FL）和 36 个（18 个 F，18 个 FL）种植体中，获得了基线和 1 年和 3 年功能后的射线照片。
总体存活率为 100%，平均 38 个月后总体平均骨损失为 1.35 毫米（SD 0.91；范围 0-3.7）。F 和 FL 两组在第一年都出现了骨量增加，FL 组的骨量丢失高于 F 组（p<.01）。此后，没有进一步的骨丢失，两组在统计学上相等（p>.7）。在个体种植体水平上，F 和 FL 组中近 80%的种植体被认为是成功的，其骨损失在 1.5 到 1.9 毫米之间。
无论手术技术如何，单个种植体都能获得良好的预后和稳定的骨水平，徒手无瓣手术是更广泛规划的引导手术的可行替代方案。适当的病例选择和临床经验被认为是可预测治疗结果的前提条件。
