Pieri Francesco, Aldini Nicolò Nicoli, Fini Milena, Marchetti Claudio, Corinaldesi Giuseppe
Oral and Maxillofacial Surgery Unit, Department of Dental Sciences, University of Bologna, Bologna, Italy.
J Periodontol. 2009 Nov;80(11):1883-93. doi: 10.1902/jop.2009.090227.
The present study evaluated the efficacy of a treatment consisting of placing and immediately loading implants with a bar-retained overdenture in edentulous maxillae.
Twenty-two consecutive patients were treated with four or five implants rigidly connected with a bar, which were then loaded with a maxillary overdenture within 48 hours post-surgery. The patients were followed clinically and radiographically for 1 year after loading. The implant outcome with regard to survival and success was analyzed. Visual analog scale questionnaires were used to record patient function and satisfaction before and after implant treatment.
Of the 103 implants, three failed within 1 year. Two implants, although integrated, presented with marginal bone resorption (MBR) values higher than those proposed for successful implants. Cumulative survival and success rates of implants were 97.1% and 95.2%, respectively. The average MBR after 1 year was low (0.78 +/- 0.79 mm). The main prosthetic complication was the frequent need for complete relining of the prosthesis in the initial weeks after loading (27.2%). The questionnaire revealed a significant increase in all comfort, functional, and esthetic parameters (Friedman test; P <0.0001), except in the cleaning feasibility category; a significant decrease in satisfaction was observed in this category (Friedman test; P <0.05), indicating the difficulty patients had in maintaining a high level of oral hygiene.
These preliminary results suggest that immediate loading of multiple implants supporting a bar-retained overdenture may represent a predictable treatment option for the rehabilitation of the edentulous maxilla.
本研究评估了在上颌无牙颌中植入种植体并即刻安装杆卡式覆盖义齿的治疗效果。
连续22例患者接受治疗，植入4颗或5颗种植体并用杆进行刚性连接，术后48小时内安装上颌覆盖义齿。加载后对患者进行1年的临床和影像学随访。分析种植体的生存和成功情况。使用视觉模拟量表问卷记录种植治疗前后患者的功能和满意度。
103颗种植体中，3颗在1年内失败。2颗种植体虽已整合，但边缘骨吸收（MBR）值高于成功种植体的标准值。种植体的累积生存率和成功率分别为97.1%和95.2%。1年后的平均MBR较低（0.78±0.79mm）。主要的修复并发症是在加载后的最初几周内频繁需要对义齿进行全衬（27.2%）。问卷显示，除清洁可行性类别外，所有舒适度、功能和美学参数均有显著提高（Friedman检验；P<0.0001）；在该类别中观察到满意度显著下降（Friedman检验；P<0.05），表明患者在保持高水平口腔卫生方面存在困难。
这些初步结果表明，即刻加载多个支持杆卡式覆盖义齿的种植体可能是上颌无牙颌修复的一种可预测的治疗选择。
