Karakoca Nemli Secil, Aydin Cemal, Yilmaz Handan, Sarisoy Senol, Kasko Yeliz
Department of Prosthodontics, Faculty of Dentistry, Gazi University, 8 Cadde, 82 Sokak, 06510, Emek, Ankara, Turkey.
J Craniofac Surg. 2010 Jul;21(4):1178-83. doi: 10.1097/SCS.0b013e3181e2083a.
Extraoral implants provide the prostheses excellent stability and retention. However, the use of implants in the orbit showed questionable survival rates. Furthermore, evaluation of this treatment from the patients' point of view is lacking in clinical studies. The purpose of this study was to evaluate outcomes of implant-retained prosthetic treatment of orbital defects in implant survival, peri-implant soft tissue health, and patients' satisfaction.
Extraoral implants were placed in the orbital defects. After a 3- to 6-month osseointegration period, prostheses were fabricated. Recall examinations were performed 1 week and 3 and 6 months after prosthesis insertion, subsequently, every 6 months. Implant survival was estimated using the Kaplan-Meier method. A 5-point scale was used to record tissue health. A questionnaire was applied to obtain the patients' perceptions of prosthesis after insertion and at 1-year recall.
A total of 36 patients (17 men and 19 women) with 109 implants were evaluated. Mean age was 44.8 (18.3) years. The overall cumulative survival rate was 69.4%; 75% for nonirradiated patients and 62.5% for irradiated patients. Three months after prostheses insertion, no skin reaction was observed in 12 patients, grade 1 and 2 reactions was observed in 16 patients, and granulation was observed in 7 patients. In 2 years, grade 2 and 3 reactions decreased. Slight incensement was observed in skin reactions after the second year. Patients' satisfaction on appearance decreased after 1 year. A statistically significant increase was found in comfort, retention, ease of use, and self-confidence (P < 0.05).The long-term predictability of orbital implants is still questionable. Therefore, orbital implants should be used in patients who understand complications, and meticulous hygiene is required. Although complications are relatively frequent in the orbit, implant-retained prostheses enhance the patients' quality of life, providing self-confidence.
口外种植体可为假体提供出色的稳定性和固位力。然而，在眼眶中使用种植体的生存率存在疑问。此外，临床研究缺乏从患者角度对这种治疗方法的评估。本研究的目的是评估种植体支持的眶缺损修复治疗在种植体存留率、种植体周围软组织健康状况以及患者满意度方面的效果。
在眶缺损处植入口外种植体。经过3至6个月的骨整合期后，制作假体。在假体植入后1周、3个月和6个月进行复查，随后每6个月复查一次。采用Kaplan-Meier法评估种植体存留率。使用5分制记录组织健康状况。应用问卷调查以获取患者在假体植入后及1年复查时对假体的看法。
共评估了36例患者（17例男性和19例女性），植入109枚种植体。平均年龄为44.8（18.3）岁。总体累积存留率为69.4%；未接受放疗的患者为75%，接受放疗的患者为62.5%。假体植入3个月后，12例患者未观察到皮肤反应，16例患者观察到1级和2级反应，7例患者观察到肉芽组织。2年内，2级和3级反应有所减少。第二年之后皮肤反应略有增加。患者对外观的满意度在1年后下降。舒适度、固位力、易用性和自信心方面有统计学显著提高（P<0.05）。眼眶种植体的长期可预测性仍存在疑问。因此，眼眶种植体应仅用于了解并发症情况的患者，并且需要严格的口腔卫生。尽管眼眶并发症相对常见，但种植体支持的假体可提高患者的生活质量，增强自信心。
