Kim Young-Kyun, Kim Su-Gwan, Park Jin-Young, Yi Yang-Jin, Bae Ji-Hyun
Department of Oral and Maxillofacial Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Feb;111(2):164-9. doi: 10.1016/j.tripleo.2010.04.011. Epub 2010 Jul 24.
The aim of this study was to compare the survival rate and surrounding tissue condition of sinus bone grafts with simultaneous implant placement between 4-month and 6-month occlusal loading after implantation.
Twenty-seven patients (61 implants) who were treated with sinus bone grafts (sinus lateral approach) and simultaneous Osstem GS II implant placement from July 2007 to June 2008 were included in this study. Of these patients, 14 (31 implants) were in the 4-month loading group, and 13 (30 implants) were in the 6-month loading group. We investigated the implantation type (submerged or nonsubmerged), sinus membrane perforation, type of prosthesis, opposed tooth type, primary and secondary stability of implants, and crestal bone loss around implant and surrounding tissue conditions.
The amounts of crestal bone-loss at the final recall time (12.56 ± 5.95 mo after loading) of the 4-month and 6-month loading groups were 0.19 ± 0.33 mm and 0.39 ± 0.86 mm, respectively. However, the difference between groups was not statistically significant (P = .211). The width of keratinized mucosa, gingival index, plaque index, and pocket depth of the 4-month and 6-month loading groups were 2.50 ± 1.69 mm and 1.73 ± 1.40 mm (P = .081), 0.72 ± 0.83 and 0.59 ± 0.69 (P = .671), 1.11 ± 0.96 and 0.76 ± 0.79 (P = .226), 3.56 ± 0.98 mm and 3.65 ± 1.06 mm (P = .758), respectively. The primary stabilities of implants in the 4-month and 6-month loading groups were 61.96 ± 12.84 and 56.06 ± 15.55 (P = .120), and the secondary stabilities were 71.85 ± 6.80 and 66.51 ± 11.28 (P = .026), respectively. The secondary stability of the 4-month group was significantly higher than that of the 6-month group. There was no statistical difference (P > .05) between the 4-month and 6-month loading groups regarding the implantation type (submerged or nonsubmerged), sinus membrane perforation, type of prosthesis, or opposed tooth type. In the 4-month and 6-month groups, all of the implants survived until the final recall time.
For the cases in which the residual bone was >3 mm and primary implant stability could be obtained, we conclude that loading is possible 4 months after the sinus bone graft and simultaneous implant placement.
本研究旨在比较种植后4个月和6个月咬合加载时,同期植入种植体的上颌窦骨移植的存活率及周围组织状况。
本研究纳入了2007年7月至2008年6月期间接受上颌窦骨移植(上颌窦外侧入路)并同期植入Osstem GS II种植体的27例患者(61枚种植体)。其中,14例患者(31枚种植体)为4个月加载组,13例患者(30枚种植体)为6个月加载组。我们调查了种植类型(潜入式或非潜入式)、上颌窦膜穿孔情况、修复体类型、对颌牙类型、种植体的初期和二期稳定性,以及种植体周围的牙槽嵴骨吸收和周围组织状况。
4个月加载组和6个月加载组在最终复查时(加载后12.56±5.95个月)的牙槽嵴骨吸收量分别为0.19±0.33mm和0.39±0.86mm。然而,两组之间的差异无统计学意义(P = 0.211)。4个月加载组和6个月加载组的角化黏膜宽度、牙龈指数、菌斑指数和牙周袋深度分别为2.50±1.69mm和1.73±1.40mm(P = 0.081)、0.72±0.83和0.59±0.69(P = 0.671)、1.11±0.96和0.76±0.79(P = 0.226)、3.56±0.98mm和3.65±1.06mm(P = 0.758)。4个月加载组和6个月加载组种植体的初期稳定性分别为61.96±12.84和56.06±15.55(P = 0.120),二期稳定性分别为71.85±6.80和66.51±11.28(P = 0.026)。4个月组的二期稳定性显著高于6个月组。4个月加载组和6个月加载组在种植类型(潜入式或非潜入式)、上颌窦膜穿孔情况、修复体类型或对颌牙类型方面无统计学差异(P>0.05)。在4个月组和6个月组中,所有种植体均存活至最终复查时。
对于剩余骨量>3mm且能获得种植体初期稳定性的病例,我们得出结论,在上颌窦骨移植并同期植入种植体后4个月即可进行加载。