Department of Periodontology and Oral Implantology, University of Ghent, Ghent, Belgium.
Clin Oral Implants Res. 2010 Nov;21(11):1223-33. doi: 10.1111/j.1600-0501.2010.01924.x.
To evaluate and compare the outcome of dental implants placed using a flapless protocol and immediate loading with a conventional protocol and loading after 6 weeks.
Fourteen patients with bilateral maxillary edentulous areas were treated using Straumann SLA-implants. Using a randomized split-mouth design, implants were placed in one side of the maxilla using a stereolithographic surgical guide for flapless surgery and immediately loaded on temporary abutments with a bridge (test). Implants in the other side were placed using the conventional protocol and loaded after 6 weeks of healing (control). Clinical and radiographic evaluation of peri-implant tissues was performed at time of implant surgery, and after 1 week, 6 weeks, 3, 6, 12 and 18 months.
A total of 70 implants were placed (36 test and 34 control). One implant (test) was lost after 3 months, resulting in a survival rate of 97.3% for the test implants and 100% for the control implants. Marginal bone levels were not statistically significantly different between the test and control implants but at baseline the marginal bone level was significantly lower compared to the other evaluation periods (P < 0.05). The mean bone level for test and control implants was 1.95 mm ± 0.70 and 1.93 mm ± 0.42 after 18 months, respectively. There was a significant change in height of the attached mucosa at implants placed with a conventional flap between post-operative and 1 week and between 1 week and 6 weeks. Statistically significant differences were found between the test side and the control side for opinion about speech, function, aesthetics, self-confidence and overall appreciation the first 6 weeks.
Implants can successfully integrate in the posterior maxilla using a flapless approach with immediate loading similar to a conventional protocol. The mucosal tissues around implants placed with a conventional flap changed significantly compared with flapless placed implants.
评估和比较无瓣方案和常规方案植入物的即刻负载与 6 周后负载的结果。
14 名双侧上颌无牙区患者采用 Straumann SLA 种植体进行治疗。采用随机分组的方法，使用立体光刻手术导板在上颌骨一侧无瓣手术中放置种植体，并立即用临时基台和桥体（试验组）加载。另一侧植入物采用常规方案植入，6 周愈合后加载（对照组）。在植入手术时、植入后 1 周、6 周、3 个月、6 个月、12 个月和 18 个月对种植体周围组织进行临床和影像学评估。
共植入 70 个种植体（试验组 36 个，对照组 34 个）。试验组有 1 个种植体（试验组）在 3 个月后脱落，试验组种植体的存活率为 97.3%，对照组为 100%。试验组和对照组的边缘骨水平无统计学差异，但基线时边缘骨水平明显低于其他评估期（P<0.05）。试验组和对照组种植体的平均骨水平分别为 1.95mm±0.70mm 和 1.93mm±0.42mm，18 个月后。常规瓣植入后种植体附着黏膜高度在术后至 1 周及 1 周至 6 周之间有显著变化。在术后前 6 周，试验侧和对照侧在对言语、功能、美观、自信和整体满意度的评价方面存在显著差异。
无瓣即刻负载方案在上颌后牙区植入物植入中可获得与常规方案相似的成功率。与无瓣植入物相比，常规瓣植入物周围的黏膜组织变化明显。
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