Guljé Felix, Abrahamsson Ingemar, Chen Stephen, Stanford Clark, Zadeh Homayoun, Palmer Richard
Private practice "de Mondhoek", Apeldoorn, The Netherlands.
Clin Oral Implants Res. 2013 Dec;24(12):1325-31. doi: 10.1111/clr.12001. Epub 2012 Sep 3.
In cases with limited bone height, short implants could be a good alternative to augmentation procedures. The aim of this randomized controlled trial was to compare the clinical performance of implants of 6 mm or 11 mm in length in the posterior region.
In this multicenter trial (six study sites), 95 subjects were included. Subjects were randomly allocated to receiving implants with lengths of either 6 or 11 mm both with a diameter of 4 mm (OsseoSpeed(™) 4.0 S; Astra Tech AB; Mölndal, Sweden). In all cases, there had to be sufficient bone height to allow placement of an implant of at least 11 mm in length. Two or three implants were placed per subject using one-stage surgery with a 42-48 days' healing period before loading. They were restored with a screw-retained splinted fixed prosthesis. Clinical and radiographic examinations were performed preoperatively, postsurgery, at loading, and 6 and 12 months after prosthesis placement.
A total of 208 implants were inserted in 49 subjects receiving 6-mm implants (test) and in 46 subjects receiving 11 mm implants (control). Two 6-mm implants failed before loading and one 6 and 11 mm implants failed before 1-year evaluation. From loading to the 12 months' follow-up, a mean marginal bone gain of 0.06 mm in the 6 mm group and 0.02 mm in the 11 mm group was found (P = 0.478). Soft tissue behavior was equal in both groups (Bleeding and plaque [P = 1.0] probing depth [P = 0.91]).
One-year data indicate that treatment with the 6 mm implants is as reliable as treatment with the 11 mm implants. This provides a good treatment option in situations with limited bone height in the premolar and molar regions. Whether or not short implants provide a predictable treatment alternative to bone augmentation procedures remains to be investigated in the future randomized controlled clinical trials.
在骨高度有限的病例中，短种植体可能是增量手术的良好替代方案。本随机对照试验的目的是比较后牙区6毫米或11毫米长度种植体的临床性能。
在这项多中心试验（六个研究地点）中，纳入了95名受试者。受试者被随机分配接受直径均为4毫米的6毫米或11毫米长度的种植体（OsseoSpeed(™) 4.0 S；Astra Tech AB；瑞典默恩达尔）。在所有病例中，必须有足够的骨高度以允许植入至少11毫米长的种植体。每位受试者使用一期手术植入两到三颗种植体，在加载前有42 - 48天的愈合期。使用螺丝固位的夹板固定修复体进行修复。在术前、术后、加载时以及修复体植入后6个月和12个月进行临床和影像学检查。
共有208颗种植体分别植入49名接受6毫米种植体（试验组）和46名接受11毫米种植体（对照组）的受试者中。两颗6毫米种植体在加载前失败，一颗6毫米和一颗11毫米种植体在1年评估前失败。从加载到12个月随访，6毫米组平均边缘骨增量为0.06毫米，11毫米组为0.02毫米（P = 0.478）。两组软组织情况相同（出血和菌斑[P = 1.0]、探诊深度[P = 0.91]）。
一年的数据表明，6毫米种植体治疗与11毫米种植体治疗一样可靠。这为前磨牙和磨牙区骨高度有限的情况提供了一个良好的治疗选择。短种植体是否能为骨增量手术提供可预测的治疗替代方案，仍有待未来的随机对照临床试验进行研究。
