Department of Prosthodontics, University of Heidelberg, Heidelberg, Germany.
Clin Oral Implants Res. 2010 Mar;21(3):284-9. doi: 10.1111/j.1600-0501.2009.01843.x. Epub 2010 Jan 13.
The purpose of this study was to evaluate the survival and success of early-loaded implants placed in the intraforaminal area of the edentulous mandible, and the survival of the implant-supported fixed dental prostheses (FDP).
Thirty-seven patients (18.9% male, mean age 64.5 years) with edentulous lower jaws were treated with implant-supported FDPs in the mandible. One hundred and eighty-five screw-type implants were placed in the intraforaminal area of the symphysis (five implants per patient). Immediately after implant placement, a framework was fabricated and the FDP was manufactured on the framework. Within 2 weeks, the implants were rigidly connected and loaded with the implant-retained FDP.
During the 1-8-year observation period (mean 4.5 years), a total of 32 implant-retained complications occurred. Nineteen implants were lost in 10 patients, resulting in a cumulative survival of 89.7%. Nine implants in five patients did not osseointegrate. Although these implants were not removed, because stability within the connective tissue was acceptable and inflammation was absent, they were recorded as unsuccessful. Consequently, the cumulative success declined to 84.9%. Four implants in three patients had clinical signs of periimplantitis (2.2% of all implants). Denture-related complications included one complete failure, when one FDP had to be removed after the last of five implants had been replaced. Furthermore, 10 fractures of the framework occurred in six patients, three FDPs had to be adapted or modified, and the facing of the FDP had to be repaired 16 times in 11 patients.
Although one-stage early-loaded implants functioned well for most patients with edentulous mandibles, immediate loading is associated with a larger number of implant-related complications than in other studies investigating delayed loading. Because of the substantial prosthetic complications and aftercare, this procedure cannot be generally recommended.
本研究旨在评估在下颌牙槽嵴区即刻负载种植体的存活率和成功率，以及种植体支持的固定义齿（FDP）的存活率。
37 名下颌无牙患者（18.9%为男性，平均年龄 64.5 岁）接受了下颌种植体支持的 FDP 治疗。每个患者植入 5 个螺钉型种植体共 185 个，植入在下颌牙槽嵴区的正中联合部位。种植体植入后立即制作支架，并在支架上制作 FDP。在 2 周内，将种植体刚性连接并负载种植体保留的 FDP。
在 1-8 年的观察期内（平均 4.5 年），共发生 32 例种植体保留并发症。10 名患者中有 19 个种植体丢失，累积存活率为 89.7%。5 名患者中有 9 个种植体未骨整合。虽然这些种植体未被取出，但由于与结缔组织的稳定性可接受且无炎症，因此被记录为不成功。因此，累积成功率下降至 84.9%。3 名患者的 4 个种植体有种植体周围炎的临床迹象（占所有种植体的 2.2%）。义齿相关并发症包括一个 FDP 在最后 5 个种植体中的 1 个替换后完全失效。此外，6 名患者中有 10 个支架发生骨折，6 名患者中有 3 个 FDP 需要适应或修改，11 名患者中有 16 次需要修复 FDP 的饰面。
尽管在下颌牙槽嵴区即刻负载种植体对大多数无牙患者功能良好，但与其他研究延迟负载的研究相比，即刻负载与更多的种植体相关并发症相关。由于大量的修复体并发症和后续护理，该程序不能普遍推荐。
