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模板引导(NobelGuide™)治疗理念的临床与影像学评估

Clinical and radiological evaluation of a template-guided (NobelGuide™) treatment concept.

作者信息

Vasak Christoph, Kohal Ralf J, Lettner Stefan, Rohner Dennis, Zechner Werner

机构信息

Department of Oral Surgery, Bernhard Gottlieb Dental School, Medical University of Vienna, Vienna, Austria.

出版信息

Clin Oral Implants Res. 2014 Jan;25(1):116-23. doi: 10.1111/clr.12038. Epub 2012 Sep 18.

Abstract

OBJECTIVES

The study was designed to evaluate the clinical use of the NobelGuide(™) concept over a follow-up period of 12 months with respect to implant success and survival rates, development of soft tissue condition and recording of potential surgical and prosthetic complications. In addition, radiological assessment of peri-implant bone levels was performed at the 1-year follow-up post-implant placement.

MATERIAL AND METHODS

Thirty patients (male/female = 15/15) with partially dentate and edentulous mandibles and maxillae were included. All patients were planned and operated on using the computer-aided, template-guided treatment concept NobelGuide(™). Overall, 163 implants (NobelReplace(®) Tapered Groovy) were placed (mandible/maxilla = 107/56 implants). Recall appointments were performed after 1-2 weeks, 1, 3, 6 and 12 months after implant placement. Clinical parameters of the soft tissue conditions [e.g. bleeding on probing (BoP), pocket probing depth ≥3 mm (PPD), marginal plaque index (mPI)] and the dentist's esthetic and functional evaluation using a visual analogue scale (VAS) were documented. Marginal bone level was evaluated on radiographs made at implant insertion and at the 1-year follow-up.

RESULTS

All 30 patients with 161 implants completed the 1-year follow-up resulting in a cumulative survival rate of 98.8% (two implant losses). Clinical parameters improved in a majority of the implants. The mean marginal bone level at implant insertion and at 1-year follow-up was reported with 0.17 mm (SD 1.24; n = 125) and -1.39 mm (SD 1.27; n = 110), respectively. The mean change in bone level from implant insertion to 1 year was -1.44 mm (SD 1.35; n = 98).

CONCLUSIONS

The 1-year follow-up showed a cumulative survival rate and success rate of 98.8% and 96.3%, respectively. Immediate or delayed loading of implants using a flapless, guided surgery approach (NobelGuide(™)) appears to be a viable concept demonstrating good clinical and radiographic outcomes at the 1-year time point.

摘要

目的

本研究旨在评估NobelGuide™概念在12个月随访期内的临床应用情况,包括种植体的成功率和存留率、软组织状况的发展以及潜在手术和修复并发症的记录。此外,在种植体植入后1年随访时对种植体周围骨水平进行影像学评估。

材料与方法

纳入30例下颌和上颌部分牙列缺失及无牙列的患者(男/女 = 15/15)。所有患者均采用计算机辅助、模板引导的NobelGuide™治疗概念进行规划和手术。共植入163枚种植体(NobelReplace®锥形凹槽种植体)(下颌/上颌 = 107/56枚种植体)。在种植体植入后1 - 2周、1、3、6和12个月进行复诊。记录软组织状况的临床参数[如探诊出血(BoP)、探诊深度≥3 mm(PPD)、边缘菌斑指数(mPI)]以及牙医使用视觉模拟量表(VAS)进行的美学和功能评估。在种植体植入时和1年随访时拍摄的X线片上评估边缘骨水平。

结果

30例患者的161枚种植体完成了1年随访,累积存留率为98.8%(2枚种植体丢失)。大多数种植体的临床参数有所改善。种植体植入时和1年随访时的平均边缘骨水平分别报告为0.17 mm(标准差1.24;n = 125)和 - 1.39 mm(标准差1.27;n = 110)。从种植体植入到1年时骨水平的平均变化为 - 1.44 mm(标准差1.35;n = 98)。

结论

1年随访显示累积存留率和成功率分别为98.8%和96.3%。使用无瓣引导手术方法(NobelGuide™)对种植体进行即刻或延迟加载似乎是一个可行的概念,在1年时间点显示出良好的临床和影像学结果。

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