采用立体光刻引导手术植入物的临床和放射学结果：一项前瞻性单中心研究。
Clinical and radiographic outcome of implants placed using stereolithographic guided surgery: a prospective monocenter study.
机构信息
Department of Periodontology and Oral Implantology, Dental School, University of Ghent, Ghent, Belgium.
出版信息
Int J Oral Maxillofac Implants. 2013 Jan-Feb;28(1):205-15. doi: 10.11607/jomi.2618.
PURPOSE
The number of clinical reports giving detailed information on clinical outcomes with guided surgery is rather scarce despite its large-scale introduction over the last decade. The aim of this report was to determine implant survival and success in terms of peri-implant bone loss and evaluate whether smoking affects the outcome.
MATERIALS AND METHODS
A total of 26 cases with a partially or totally edentulous maxilla were selected for implant treatment using the Facilitate software system (Astra Tech). In totally edentulous cases, six fluoride-modified OsseoSpeed implants (Astra Tech) were inserted. Immediately after implantation, abutments were screwed onto the implants. Within 8 hours, a provisional screw-retained fiber-reinforced acrylic fixed dental prosthesis was screwed on the abutments. For the partial cases, the surgical guide rested on the remaining teeth and implants were not immediately loaded.
RESULTS
In total 13 out of 114 implants were lost within 12 months after surgery, resulting in 88.6% survival at 1 year. Twelve of those failures occurred in smokers, leading to 69.2% implant survival compared to 98.7% in nonsmokers. Implants were lost in 7 out of 26 (26.9%) patients; only 1 out of 17 nonsmokers (5.9%) compared to 6 out of 9 (66.7%) smokers lost one or more implants. In total, 38.5% of the subjects with a full immediately loaded fixed dental prosthesis experienced implant failures compared with 15.4% of the partially delayed loaded cases. The overall mean bone loss based on all implants was 0.47 mm (SD, 0.94). Mean bone loss was 0.36 mm for nonsmokers and 0.62 mm for smokers.
CONCLUSIONS
On the basis of the current case control study, it is tempting to suggest that smoking is an exclusion factor when placing implants using stereolithographic guided surgery in conjunction with immediate loading. There is still not enough scientific evidence to show if this method is as safe and predictable as the traditional method.
目的
尽管引导式手术在过去十年中得到了广泛的应用，但提供详细临床结果信息的临床报告数量相当有限。本报告的目的是确定种植体的存活率和成功率，包括种植体周围骨丢失，并评估吸烟是否会影响结果。
材料和方法
选择 26 例上颌部分或完全无牙患者，使用 Facilitate 软件系统（AstraTech）进行种植体治疗。在完全无牙的情况下，植入六颗氟改性 OsseoSpeed 种植体（AstraTech）。植入后立即将基台拧入种植体。在 8 小时内，将临时螺钉固位纤维增强丙烯酸固定义齿拧接到基台上。对于部分病例，手术导板置于剩余牙齿上，种植体不立即负载。
结果
术后 12 个月内共有 13 颗种植体（114 颗中的 13 颗）丢失，1 年时存活率为 88.6%。其中 12 个失败发生在吸烟者中，导致种植体存活率为 69.2%，而不吸烟者为 98.7%。26 名患者中有 7 名（26.9%）失牙；不吸烟者中有 1 名（5.9%），吸烟者中有 6 名（66.7%）失牙。共有 38.5%的全口即刻负载固定义齿患者发生种植体失败，而部分延迟负载病例为 15.4%。所有植入物的总体平均骨丢失为 0.47 毫米（标准差，0.94）。不吸烟者的平均骨丢失为 0.36 毫米，吸烟者为 0.62 毫米。
结论
根据目前的病例对照研究，当使用立体光刻引导手术结合即刻负载放置种植体时，吸烟似乎是一个排除因素。目前还没有足够的科学证据表明这种方法是否像传统方法一样安全和可预测。
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