Researcher, Head of Section of Oral Physiology, Department of Health Technologies, Center of Research in Oral Implantology, University of Milano, Milan, Italy.
Clin Implant Dent Relat Res. 2012 Aug;14(4):612-21. doi: 10.1111/j.1708-8208.2010.00288.x. Epub 2010 May 13.
The aim of this review was to evaluate the survival rate of upright and tilted implants supporting fixed prosthetic reconstructions for the immediate rehabilitation of partially and fully edentulous jaws, after at least 1 year of function.
An electronic search of databases plus a hand search on the most relevant journals up to December 2009 was performed. The articles were selected using specific inclusion criteria, independent of the study design.
The literature search yielded 347 articles. A first screening based on the title and abstract identified 25 eligible studies. After full-text review of these studies, 10 articles were selected for analysis. Seven were prospective single-cohort studies and three had a retrospective design. A total of 462 patients have been rehabilitated with 470 immediately loaded prostheses (257 in the maxilla, 213 in the mandible), supported by a total of 1,992 implants (1,026 upright and 966 tilted). Twenty-five implants (1.25%) failed in 20 patients within the first year. All failures except one occurred in the maxilla. No significant difference in failure rate was found between tilted and upright implants, nor between maxillary and mandibular implants. No prosthesis failure was reported. Limited peri-implant bone loss was reported with no difference between upright and tilted implants. Full patients' satisfaction for function, phonetics, and esthetics was reported in three studies, based on questionnaires.
The use of tilted implants to support immediately loaded fixed prostheses for the rehabilitation of edentulous jaws can be considered a predictable technique, with an excellent prognosis in the short-medium term. However, randomized long-term trials are needed to determine the efficacy of this surgical approach.
本综述的目的在于评估在至少 1 年的功能期后，垂直和倾斜种植体支持固定修复体即刻修复部分和完全无牙颌的存活率。
通过电子数据库检索和 2009 年 12 月前对最相关期刊的手工检索，进行了本次研究。使用特定的纳入标准，独立于研究设计，选择这些文章。
文献检索得到 347 篇文章。根据标题和摘要进行初步筛选，确定了 25 项合格研究。对这些研究进行全文审查后，选择了 10 项进行分析。其中 7 项为前瞻性单队列研究，3 项为回顾性设计。共有 462 名患者接受了 470 个即刻负重修复体（上颌 257 个，下颌 213 个）的修复，共植入 1992 个种植体（垂直植入 1026 个，倾斜植入 966 个）。在第 1 年内，20 名患者中有 25 个种植体（1.25%）失败。除 1 个外，所有失败均发生在上颌。未发现倾斜种植体和垂直种植体之间、上颌种植体和下颌种植体之间的失败率有显著差异。未报告修复体失败。基于问卷调查，报告称在三个研究中，垂直和倾斜种植体的周围骨质吸收有限，无显著差异。
使用倾斜种植体支持即刻负重固定修复体修复无牙颌可以被认为是一种可预测的技术，在短中期具有良好的预后。然而，需要进行随机的长期临床试验来确定这种手术方法的疗效。
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