Hoffmann Oliver, Zafiropoulos Gregory-George
Department of Periodontics, Loma Linda University, Loma Linda, Calif., USA.
J Oral Implantol. 2012 Apr;38(2):194-200. doi: 10.1563/AAID-JOI-D-10-00071. Epub 2010 Nov 23.
The aim of this review was to assess the long-term outcomes of restorations supported by implants and natural teeth with regard to complications associated with implants, teeth, and restorations, as well as the influence on these parameters of the connector type used. A net-based search in PubMed was combined with a manual search. Clinical studies, reviews, and biomechanical studies were included. Information on survival rate, complication rate, incidence of tooth intrusion, and, where applicable, type of connector used, was retrieved from the clinical studies. Force distribution and types of connectors used were retrieved from the biomechanical study. A summary of outcomes was retrieved from the reviews. A total of 25 articles were selected for inclusion in this review, including clinical studies (15), biomechanical studies (7), and reviews (3). Implant success rates ranged from 79.5%-100%. Tooth complications occurred in 5.4%-11.8% of cases. Complications in the suprastructure were observed in 5%-90% of cases. Tooth intrusion presented in a total of 0%-66% of all cases, more often in cases with nonrigid connection (0%-66%) than in cases with rigid connection (0%-44%). Biomechanical studies show a large difference in stress distribution and in dependence on the type of connector used, with most studies demonstrating that nonrigid connectors drastically reduce stress on the suprastructure while increasing forces on supporting teeth and implants. Long-term success rates for tooth-implant connections are lower than for solely implant-supported restorations with regard to prognosis for teeth, implants, and suprastructure. Use of rigid connectors leads to more favorable clinical outcomes in terms of long-term stability, occurrence of complications, and tooth intrusion.
本综述的目的是评估种植体和天然牙支持的修复体的长期效果，包括与种植体、牙齿和修复体相关的并发症，以及所使用的连接体类型对这些参数的影响。在PubMed上进行基于网络的搜索，并结合手动搜索。纳入临床研究、综述和生物力学研究。从临床研究中获取关于生存率、并发症发生率、牙齿侵入发生率以及（如适用）所使用连接体类型的信息。从生物力学研究中获取力的分布和所使用连接体的类型。从综述中获取结果总结。本综述共纳入25篇文章，包括临床研究（15篇）、生物力学研究（7篇）和综述（3篇）。种植体成功率在79.5% - 100%之间。5.4% - 11.8%的病例出现牙齿并发症。5% - 90%的病例观察到上部结构并发症。在所有病例中，牙齿侵入的发生率总计为0% - 66%，在非刚性连接的病例中（0% - 66%）比在刚性连接的病例中（0% - 44%）更常见。生物力学研究表明，应力分布存在很大差异，且取决于所使用连接体的类型，大多数研究表明，非刚性连接体可大幅降低上部结构的应力，同时增加支持牙齿和种植体上的力。就牙齿、种植体和上部结构的预后而言，牙 - 种植体连接的长期成功率低于单纯种植体支持的修复体。使用刚性连接体在长期稳定性、并发症发生率和牙齿侵入方面会带来更有利的临床结果。
