Curi Marcos Martins, Oliveira Marcelo Ferraz, Molina Giuliano, Cardoso Camila Lopes, Oliveira Loretta De Groot, Branemark Per-Ingvar, Ribeiro Karina de Cássia Braga
Chairman of Department of Stomatology, Hospital Santa Catarina, São Paulo, Brazil.
J Oral Maxillofac Surg. 2012 Jul;70(7):1551-7. doi: 10.1016/j.joms.2012.03.011.
Few reports have evaluated cumulative survival rates of extraoral rehabilitation and peri-implant soft tissue reaction at long-term follow-up. The objective of this study was to evaluate implant and prosthesis survival rates and the soft tissue reactions around the extraoral implants used to support craniofacial prostheses.
A retrospective study was performed of patients who received implants for craniofacial rehabilitation from 2003 to 2010. Two outcome variables were considered: implant and prosthetic success. The following predictor variables were recorded: gender, age, implant placement location, number and size of implants, irradiation status in the treated field, date of prosthesis delivery, soft tissue response, and date of last follow-up. A statistical model was used to estimate survival rates and associated confidence intervals. We randomly selected 1 implant per patient for analysis. Data were analyzed using the Kaplan-Meier method and log-rank test to compare survival curves.
A total of 150 titanium implants were placed in 56 patients. The 2-year overall implant survival rates were 94.1% for auricular implants, 90.9% for nasal implants, 100% for orbital implants, and 100% for complex midfacial implants (P = .585). The implant survival rates were 100% for implants placed in irradiated patients and 94.4% for those placed in nonirradiated patients (P = .324). The 2-year overall prosthesis survival rates were 100% for auricular implants, 90.0% for nasal implants, 92.3% for orbital implants, and 100% for complex midfacial implants (P = .363). The evaluation of the peri-implant soft tissue response showed that 15 patients (26.7%) had a grade 0 soft tissue reaction, 30 (53.5%) had grade 1, 6 (10.7%) had grade 2, and 5 (8.9%) had grade 3.
From this study, it was concluded that craniofacial rehabilitation with extraoral implants is a safe, reliable, and predictable method to restore the patient's normal appearance.
很少有报告评估长期随访时口外修复的累积生存率和种植体周围软组织反应。本研究的目的是评估用于支持颅面修复体的口外种植体的种植体和修复体生存率以及种植体周围的软组织反应。
对2003年至2010年接受颅面修复种植体的患者进行回顾性研究。考虑了两个结果变量：种植体和修复体的成功。记录了以下预测变量：性别、年龄、种植体植入位置、种植体数量和尺寸、治疗区域的照射状态、修复体交付日期、软组织反应以及最后随访日期。使用统计模型估计生存率和相关的置信区间。我们为每位患者随机选择1枚种植体进行分析。使用Kaplan-Meier方法和对数秩检验分析数据以比较生存曲线。
共为56例患者植入了150枚钛种植体。耳种植体的2年总体种植体生存率为94.1%，鼻种植体为90.9%，眶种植体为100%，复杂面中部种植体为100%（P = 0.585）。接受照射患者植入的种植体生存率为100%，未接受照射患者植入的种植体生存率为94.4%（P = 0.324）。耳种植体的2年总体修复体生存率为100%，鼻种植体为90.0%，眶种植体为92.3%，复杂面中部种植体为100%（P = 0.363）。种植体周围软组织反应评估显示，15例患者（26.7%）软组织反应为0级，30例（53.5%）为1级，6例（10.7%）为2级，5例（8.9%）为3级。
从本研究得出结论，口外种植体进行颅面修复是恢复患者正常外观的一种安全、可靠且可预测的方法。
