Zoghbi Sumaia Ahmad, de Lima Luiz A Pugliese Alves, Saraiva Luciana, Romito Giuseppe Alexandre
Periodontics Department, School of Dentistry, University of São Paulo, Brazil.
J Oral Maxillofac Surg. 2011 Nov;69(11):2771-6. doi: 10.1016/j.joms.2011.03.031. Epub 2011 Jul 27.
With the increasing number of surgical procedures for osseointegrated implant placement, there has also been an increase in the number of professionals performing this procedure. Surgeons undergo different types of training, and this may influence their surgical experience. The objective of this study was to evaluate the effect of surgical experience on the osseointegration of dental implants.
A retrospective study was conducted using clinical charts from 2002 through 2008, during which time 265 implants were performed in 110 patients by 2 professionals who completed a postgraduate program in implant dentistry in 2002. Cases were selected for degree of difficulty, avoiding those involving areas that required bone grafts for the placement of implants, with a regular platform (3.75) and a height ranging from 10 to 13 mm. The criteria for evaluating implant osseointegration included clinical and radiographic evidence observed for a minimum period of 1 year, in accordance with the success criteria proposed by Albrektsson et al:(1)1) individual, unattached implant is immobile when tested clinically; 2) radiograph does not demonstrate evidence of peri-implant radiolucency; 3) vertical bone loss is less than 0.2 mm annually after the first year postimplantation; and 4) individual implant performance is characterized by an absence of signs and symptoms such as pain, infections, neuropathies, paresthesia, or violation of the mandibular canal. Implantation was performed in 2 stages. To relate the osseointegration rate with professional experience, cases were arranged by increasing order of placement date and were then evaluated per year and region. They were then separated into 2 groups: first 50 implants performed and implants performed after the first 50.
The osseointegration rate of implants performed was 92.5%, with rates of 87.6% for those placed in the maxilla and 95.6% for those in the mandible. For the first 50 implants, the osseointegration rate was 84.0%, whereas in the implants performed thereafter, the rate was 94.4%.
Surgical experience acquired during and after a postgraduate program in implant dentistry appears to influence osseointegration of dental implants, with a higher osseointegration rate found in implants performed by more experienced professionals.
随着骨结合种植体植入手术数量的增加，实施该手术的专业人员数量也在增多。外科医生接受不同类型的培训，这可能会影响他们的手术经验。本研究的目的是评估手术经验对牙种植体骨结合的影响。
采用2002年至2008年的临床图表进行回顾性研究，在此期间，两名于2002年完成种植牙科研究生课程的专业人员为110例患者植入了265枚种植体。根据难度程度选择病例，避免选择那些需要植骨来植入种植体的区域，种植体为常规平台（3.75），高度在10至13毫米之间。评估种植体骨结合的标准包括临床和影像学证据，观察期至少为1年，符合阿尔布雷克特松等人提出的成功标准：（1）1）单个未附着的种植体在临床测试时无松动；2）X线片未显示种植体周围有透射区；3）种植后第一年起每年垂直骨吸收小于0.2毫米；4）单个种植体的表现为无疼痛、感染、神经病变、感觉异常或侵犯下颌管等体征和症状。种植分两期进行。为了将骨结合率与专业经验相关联，病例按植入日期升序排列，然后每年和按区域进行评估。然后将它们分为两组：前50枚植入的种植体和前50枚之后植入的种植体。
植入种植体的骨结合率为92.5%，上颌种植体的骨结合率为87.6%，下颌种植体的骨结合率为95.6%。前50枚种植体的骨结合率为84.0%，而此后植入的种植体骨结合率为94.4%。
在种植牙科研究生课程期间及之后获得的手术经验似乎会影响牙种植体的骨结合，经验更丰富的专业人员植入的种植体骨结合率更高。
