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[牙周炎患者种植体即刻负重的临床观察]

[Clinical observation of implant immediate loading in periodontitis patients].

作者信息

Deng Fei-long, Zhang Hua, Zhang Quan

机构信息

Department of Oral Implantology, Guanghua School and Hospital of Stomatology & Institute of Stomatological Research, Sun Yat-sen University, Guangzhou 510055, China.

出版信息

Zhonghua Kou Qiang Yi Xue Za Zhi. 2011 Nov;46(11):646-9.

Abstract

OBJECTIVE

To evaluate the clinical performance of implants placed immediately after extraction of remaining teeth due to severe periodontitis and immediately loaded for prosthetic oral rehabilitation.

METHODS

Twelve patients in need of complete maxillary or mandibular rehabilitations due to severe periodontitis were enrolled in this study and received periodontal treatment for management of periodontitis. The remaining teeth were extracted, debridement around the periodontally compromised sites was performed. The implants were inserted under guidance by a surgical template, and a prefabricated screwed-retained provisional restoration was immediately delivered on implants. Definitive prostheses were inserted after 6 months. Clinical and radiographic analyses were performed at 1, 6, 12, 24 months.

RESULTS

A total of 84 implants were placed, 50 in the maxilla and 34 in the mandible. Thirty-two implants were placed directly in extraction sockets. Four implants in 3 patients failed within the first 6 months, resulting in a total implant survival rate of 95% (80/84). The survival rate was 92% (46/50) in the maxilla, 100% (34/34) in the mandible. Prosthetic success was 100%. All the failures occured in the first 6 months and no failure in the next two years of follow-up. The mean bone level change at 1 and 2 year were (-1.12 ± 0.18) mm and (-1.28 ± 0.14) mm. There were no significant differences in insertion torque and alveolar bone loss between the post-extraction sites and healed sites.

CONCLUSIONS

The immediate protocols in periodontally compromised maxilla or mandibular contributed to a satisfactory prosthetic success during the 2-year follow-up.

摘要

目的

评估因重度牙周炎拔除余留牙后即刻植入种植体并即刻负重进行口腔修复的临床效果。

方法

选取12例因重度牙周炎需要进行全上颌或下颌修复的患者,对其进行牙周炎治疗。拔除余留牙,对牙周病变部位周围进行清创。在手术模板引导下植入种植体,并在种植体上即刻安装预制的螺丝固位临时修复体。6个月后安装最终修复体。在1、6、12、24个月时进行临床和影像学分析。

结果

共植入84枚种植体,其中上颌50枚,下颌34枚。32枚种植体直接植入拔牙窝。3例患者的4枚种植体在最初6个月内失败,种植体总存留率为95%(80/84)。上颌存留率为92%(46/50),下颌为100%(34/34)。修复成功率为100%。所有失败均发生在最初6个月内,在接下来的两年随访中无失败病例。1年和2年时的平均骨水平变化分别为(-1.12±0.18)mm和(-1.28±0.14)mm。拔牙后植入部位与愈合部位之间的植入扭矩和牙槽骨吸收无显著差异。

结论

在牙周病变的上颌或下颌采用即刻种植方案,在2年随访期间可获得满意的修复成功率。

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