Department of Oral and Maxillofacial Surgery, Dental School, Faculty of Medicine and Health Sciences, University of Ghent, University Hospital Ghent, Ghent, Belgium.
Clin Implant Dent Relat Res. 2013 Jun;15(3):380-9. doi: 10.1111/j.1708-8208.2011.00367.x. Epub 2011 Jul 11.
Immediate loading of full-arch restorations yields good results in selected cases, but long-term follow-up and the outcome in compromised bone are scarcely evaluated.
To evaluate immediately loaded Osseotite implants (Biomet 3i, Palm Beach, FL, USA) installed in healed or grafted bone, with regard to implant survival and peri-implant bone loss up to 7 years in function.
Information was retrospectively retrieved from 83 patients' records with 749 Osseotite implants supporting immediately loaded semipermanent full-arch acrylic restorations. Five hundred sixty-eight (75.8%) implants were placed in healed bone and 181 (24.2%) in augmented bone, regenerated with sinus lifting and/or onlay/inlay grafts with/without biomaterials and membranes. Implant survival and success based on radiological peri-implant bone loss were registered. Wilcoxon rank sum tests evaluated peri-implant bone loss in compromised versus healed bone or between jaws or time intervals with p<.05 as statistically significant.
Sixteen of 749 implants failed (2.1%), 11/343 in maxilla (3.2%) and 5/406 (1.2%) in mandible. After 7 years, the cumulative failure rate was 9%. Mean peri-implant bone loss increased to 1.2 mm (SD 1.0) during the first 2 years but remained unchanged thereafter. Around implants in grafted bone, on average, 0.3 mm more bone loss was found.
The Osseotite implants offer a predictable long-term outcome in terms of implant survival and stable peri-implant bone under immediate loading even in grafted bone. However, the high incidence of technical repair because of fractures of the semipermanent provisionals requires attention because it may be negative from a cost-benefit perspective. Implants in grafted bone show a tendency to a more pronounced initial bone remodeling without clinical consequence in the long term.
全口即刻修复在某些情况下效果良好，但长期随访和骨量不足的结果很少被评估。
评估在愈合或移植骨中植入 Osseotite 种植体（Biomet 3i，Palm Beach，FL，美国）的即刻负载，其在功能上的种植体存活率和种植体周围骨丧失可达 7 年。
从 83 名患者的记录中回顾性获取信息，其中 749 个 Osseotite 种植体支持即刻负载半永久性全口丙烯酸修复体。568 个（75.8%）种植体植入愈合骨，181 个（24.2%）植入增强骨，通过窦提升和/或骨移植进行再生，有/无生物材料和膜。记录基于影像学种植体周围骨丧失的种植体存活率和成功率。Wilcoxon 秩和检验评估了骨量不足与愈合骨之间或颌骨之间或时间间隔之间的种植体周围骨丧失，p<.05 为统计学显著。
749 个种植体中有 16 个失败（2.1%），343 个上颌（3.2%）和 406 个下颌（1.2%）各 1 个。7 年后，累积失败率为 9%。种植体周围骨丧失在最初 2 年内平均增加 1.2 毫米（SD 1.0），但此后保持不变。在移植骨中的种植体周围，平均发现 0.3 毫米更多的骨丧失。
即使在移植骨中，Osseotite 种植体在即刻负载下也能提供可预测的长期种植体存活率和稳定的种植体周围骨，具有良好的长期效果。然而，由于半永久性修复体的骨折而需要进行大量技术修复的情况需要引起注意，因为从成本效益的角度来看，这可能是负面的。移植骨中的种植体显示出初始骨重塑更明显的趋势，但在长期内没有临床后果。
