Papaspyridakos Panos, Mokti Muizzaddin, Chen Chun-Jung, Benic Goran I, Gallucci German O, Chronopoulos Vasilios
Department of Prosthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece; Department of Restorative Dentistry & Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA, USA.
Clin Implant Dent Relat Res. 2014 Oct;16(5):705-17. doi: 10.1111/cid.12036. Epub 2013 Jan 11.
The treatment of mandibular edentulism with implant fixed complete dental prostheses (IFCDPs) is a routinely used treatment option.
The study aims to report the implant and prosthodontic survival rates associated with IFCDPs for the edentulous mandible after an observation period of a minimum 5 years.
An electronic MEDLINE/PubMED search was conducted to identify randomized controlled clinical trials and prospective studies with IFCDPs for the edentulous mandible. Clinical studies with at least 5-year follow-up were selected. Pooled data were statistically analyzed and cumulative implant- and prosthesis survival rates were calculated by meta-analysis, regression, and chi-square statistics. Implant-related and prosthesis-related factors were identified and their impact on survival rates was assessed.
Seventeen prospective studies, including 501 patients and 2,827 implants, were selected for meta-analysis. The majority of the implants (88.5% of all placed implants) had been placed in the interforaminal area. Cumulative implant survival rates for rough surface ranged from 98.42% (95% confidence interval [CI]: 97.98-98.86) (5 years) to 96.86% (95% CI: 96.00-97.73) (10 years); smooth surface implant survival rates ranged from 98.93% (95% CI: 98.38-99.49) (5 years) to 97.88% (95% CI: 96.78-98.98) (10 years). The prosthodontic survival rates for 1-piece IFCDPs ranged from 98.61% (95% CI: 97.80-99.43) (5 years) to 97.25% (95% CI: 95.66-98.86) (10 years).
Treatment with mandibular IFCDPs yields high implant and prosthodontic survival rates (more than 96% after 10 years). Rough surface implants exhibited cumulative survival rates similar to the smooth surface ones (p > .05) in the edentulous mandible. The number of supporting implants and the antero-posterior implant distribution had no influence (p > .05) on the implant survival rate. The prosthetic design and veneering material, the retention type, and the loading protocol (delayed, early, and immediate) had no influence (p > .05) on the prosthodontic survival rates.
采用种植体固定全口义齿（IFCDP）治疗下颌牙列缺失是一种常规的治疗选择。
本研究旨在报告在至少5年的观察期后，IFCDP治疗无牙下颌的种植体和修复体生存率。
通过电子MEDLINE/PubMED检索，以确定关于IFCDP治疗无牙下颌的随机对照临床试验和前瞻性研究。选择随访至少5年的临床研究。对汇总数据进行统计分析，并通过荟萃分析、回归分析和卡方统计计算种植体和修复体的累积生存率。确定与种植体和修复体相关的因素，并评估它们对生存率的影响。
17项前瞻性研究被纳入荟萃分析，包括501例患者和2827颗种植体。大多数种植体（占所有植入种植体的88.5%）植入了孔间区域。粗糙表面种植体的累积生存率在5年时为98.42%（95%置信区间[CI]：97.98 - 98.86），10年时为96.86%（95%CI：96.00 - 97.73）；光滑表面种植体的生存率在5年时为98.93%（95%CI：98.38 - 99.49），10年时为97.88%（95%CI：96.78 - 98.98）。一体式IFCDP的修复体生存率在5年时为98.61%（95%CI：97.80 - 99.43），10年时为97.25%（95%CI：9�.66 - 98.86）。
下颌IFCDP治疗可获得较高的种植体和修复体生存率（10年后超过96%）。在无牙下颌中，粗糙表面种植体的累积生存率与光滑表面种植体相似（p＞0.05）。支持种植体的数量和种植体的前后分布对种植体生存率无影响（p＞0.05）。修复设计、贴面材料、固位类型和加载方案（延迟、早期和即刻）对修复体生存率无影响（p＞0.05）。
