Grandi Tommaso, Guazzi Paolo, Samarani Rawad, Grandi Giovanni
Eur J Oral Implantol. 2013 Autumn;6(3):217-24.
To compare implant failure, prosthesis failure and radiographic bone level changes of immediate non-occlusal loading versus early loading in partially edentulous patients 3 years after implant placement.
A total of 80 patients with partial edentulism were selected for a two implant-supported immediate restoration and randomised to immediate loading (test group) or early loading (control group) after 2 months, 40 patients for each group. To be included in the study, implants had to be inserted with a torque ≥ 30 Ncm. In the test group, implants were provided with non-occluding temporary restorations. In the control group, healing abutments were attached and implants were left to heal nonsubmerged. Definitive prostheses were delivered 2 months after surgery with full occlusal contacts. The outcome variables were implant failure, prosthesis failure, complications and radiographic bone level changes at implants 3 years after loading. The assessor was blinded to group assignment.
Eighty-one implants were immediately loaded and 80 were early loaded. Two immediately loaded patients and 1 early loaded patient dropped out at 3 years. No implant failed. Two complications occurred in the immediate loading group and 1 in the early loading group. There were no significant differences in bone levels changes at 36 months between the two groups (P = 0.67; difference 0.2 mm; 95% CI -0.23, 0.63). Immediately loaded implants lost 0.90 mm (95% CI 0.63, 1.17) and early loaded implants 1.10 mm (95% CI 0.81, 1.39).
If adequate primary stability was achieved, no statistically significant difference in failure rates, complications or bone level changes between implants loaded immediately or early were observed 3 years after placement in partially edentulous patients.
比较部分牙列缺损患者种植体植入3年后即刻非咬合负重与早期负重的种植体失败、修复体失败及影像学骨水平变化情况。
选取80例部分牙列缺损患者进行两颗种植体支持的即刻修复,并随机分为即刻负重组(试验组)或2个月后早期负重组(对照组),每组40例。纳入研究的种植体植入时扭矩≥30 Ncm。试验组种植体安装非咬合的临时修复体。对照组安装愈合基台,种植体非潜入式愈合。术后2个月戴入具有完全咬合接触的最终修复体。观察指标为负重3年后种植体失败、修复体失败、并发症及种植体影像学骨水平变化。评估者对分组情况不知情。
81颗种植体即刻负重,80颗种植体早期负重。3年后,2例即刻负重患者和1例早期负重患者退出研究。无种植体失败。即刻负重组发生2例并发症,早期负重组发生1例并发症。两组在36个月时骨水平变化无显著差异(P = 0.67;差异0.2 mm;95%可信区间-0.23,0.63)。即刻负重种植体骨水平丧失0.90 mm(95%可信区间0.63,1.17),早期负重种植体骨水平丧失1.10 mm(95%可信区间0.81,1.39)。
在部分牙列缺损患者中,种植体植入3年后,若获得足够的初期稳定性,即刻负重与早期负重的种植体在失败率、并发症或骨水平变化方面无统计学显著差异。