School of Dental Medicine, Stony Brook University, Stony Brook, New York 11794-8700, USA.
Int J Oral Maxillofac Implants. 2013 May-Jun;28(3):841-5. doi: 10.11607/jomi.3223.
Few studies have compared the effects of immediate loading on implant prognoses in smokers and nonsmokers. The aim of this prospective study was to evaluate the long-term success of immediately loaded platform-switched implants placed in smokers and nonsmokers with edentulous jaws.
Platform-switched implants were placed using the same treatment protocol in the healed edentulous jaws of two groups of patients: group A patients had smoked at least 20 cigarettes a day for more than 10 years, and group B consisted of nonsmokers. All implants were loaded immediately with provisional fixed prostheses, and definitive cement-retained restorations were delivered 4 to 6 weeks later without removing the abutments. In a standardized follow-up protocol, the implants were evaluated clinically and radiographically at the start of loading, 4 to 6 weeks later, and annually thereafter.
Sixty-six implants (36 in the maxilla and 30 in the mandible) were placed in eight smokers. Twelve nonsmokers received 97 implants (55 in the maxilla and 42 in the mandible). During an average loading period of 62.53 (± 44.13) months for the smokers and 98.20 (± 19.53) months for the nonsmokers, three implants failed. Two failed in group A (one because of overloading and one because of peri-implanitis) and one failed in group B (overloading), resulting in implant survival rates of 97% and 99%, respectively. No significant differences were found between groups regarding plaque, bleeding, probing pocket depths, or crestal bone loss, either mesially or distally, resulting in success rates of 92.42% for group A and 98.00% for group B.
Long-term clinical outcomes for immediately loaded platform-shifted implants placed in heavy smokers appear to be comparable to those for nonsmokers if the abutments are placed on the day of surgery and never removed.
很少有研究比较吸烟和不吸烟患者中即刻负载对种植体预后的影响。本前瞻性研究旨在评估在无牙颌中植入平台转换种植体并即刻负载后，吸烟患者和不吸烟患者的长期成功率。
使用相同的治疗方案在两组患者的愈合无牙颌中植入平台转换种植体：组 A 患者每天至少吸烟 20 支，吸烟史超过 10 年；组 B 为不吸烟者。所有种植体均立即用临时固定义齿负载，4 至 6 周后，在不移除基台的情况下直接用固位螺钉固定修复体。在标准化的随访方案中，在负载开始时、4 至 6 周后以及此后每年，对种植体进行临床和影像学评估。
8 名吸烟者中植入 66 枚种植体（上颌 36 枚，下颌 30 枚），12 名不吸烟者中植入 97 枚种植体（上颌 55 枚，下颌 42 枚）。吸烟者的平均负载期为 62.53（±44.13）个月，不吸烟者的平均负载期为 98.20（±19.53）个月，期间共有 3 枚种植体失败。其中 2 枚发生在组 A（1 枚因过度负载，1 枚因种植体周围炎），1 枚发生在组 B（因过度负载），种植体存活率分别为 97%和 99%。在菌斑、出血、探诊袋深度或近远中骨吸收方面，两组之间无显著差异，组 A 的成功率为 92.42%，组 B 的成功率为 98.00%。
如果在手术当天放置基台且从不取出，对于重度吸烟者，即刻负载平台转移种植体的长期临床结果似乎与不吸烟者相似。
