Clin Oral Implants Res. 2010 May;21(5):459-65. doi: 10.1111/j.1600-0501.2009.01852.x. Epub 2010 Jan 22.
The purpose of this study was to prospectively evaluate the clinical and radiographic outcomes of immediately loaded full-arch fixed prostheses supported by a combination of axially and non-axially positioned implants in a large cohort of patients with completely edentulous jaws, up to 5 years of function.
One hundred and seventy-three edentulous patients (80 males and 93 females) were enrolled according to specific selection criteria. Each patient received a full-arch fixed prosthesis supported by two distal tilted implants and two anterior axially placed implants. The provisional functional acrylic prosthesis was delivered the same day as surgery in all cases. All cases were finalized 4-6 months later. The patients were scheduled for follow-up at 6 and 12 months of function, and annually up to 5 years. At each follow-up plaque and bleeding score was assessed and radiographic evaluation of marginal bone level was performed.
The overall follow-up range was 4-59 months. A total of 154 immediately loaded prostheses (61 in the maxilla and 93 in the mandible) were in function for at least 1 year and were considered for the analysis. Four axially placed implants failed in the maxilla and one tilted implant in the mandible, all within 6 months of loading. No further implant failure occurred to date. Implant survival at 1 year was 98.36% and 99.73% for the maxilla and the mandible, respectively. Marginal bone loss at 1 year averaged 0.9+/-0.7 mm in the maxilla (204 implants) and 1.2+/-0.9 mm in the mandible (292 implants). No difference was found in marginal bone loss between axial and tilted implants. Plaque and bleeding scores progressively improved from 6 to 12 months. Fracture of the acrylic prosthesis occurred in 14% of total cases.
The present preliminary results from a relatively large sample size suggest that the present technique can be considered a viable treatment option for the immediate rehabilitation of both mandible and maxilla.
本研究前瞻性评估了在完全无牙颌患者中，使用轴向和非轴向位置种植体组合支撑的全口固定义齿即刻负载的临床和影像学结果，随访时间长达 5 年。
根据特定的选择标准，共纳入 173 名无牙颌患者（80 名男性和 93 名女性）。每位患者均接受了由两个远中倾斜种植体和两个前牙轴向种植体支撑的全口固定义齿修复。所有情况下，当天手术即交付临时功能丙烯酸基托。所有病例均在 4-6 个月后完成。患者在功能的第 6 个月和第 12 个月以及之后每年随访，随访时间长达 5 年。每次随访时均评估菌斑和出血评分，并进行边缘骨水平的放射影像学评估。
总的随访时间为 4-59 个月。共有 154 个即刻负载义齿（上颌 61 个，下颌 93 个）在功能至少 1 年，被纳入分析。4 个轴向种植体在上颌失败，1 个倾斜种植体在下颌失败，均在负载后 6 个月内。迄今为止，没有进一步的种植体失败。上颌和下颌的 1 年种植体存活率分别为 98.36%和 99.73%。上颌（204 个种植体）和下颌（292 个种植体）的 1 年边缘骨平均损失分别为 0.9+/-0.7mm 和 1.2+/-0.9mm。轴向和倾斜种植体之间的边缘骨损失无差异。菌斑和出血评分从 6 个月到 12 个月逐渐改善。丙烯酸基托的断裂发生在 14%的总病例中。
来自相对较大样本量的初步结果表明，该技术可被视为即刻修复下颌和上颌的可行治疗选择。
