Andersson Peter, Degasperi Werner, Verrocchi Damiano, Sennerby Lars
Private practice, Feltre, Italy.
private practice, Fiera Di Primiero, Italy.
Clin Implant Dent Relat Res. 2015 Aug;17(4):646-57. doi: 10.1111/cid.12183. Epub 2013 Dec 3.
Full-arch clearances of compromised teeth and placement of implant-supported prostheses is one solution for the prosthetic rehabilitation of partially dentate patients.
To retrospectively evaluate treatment outcomes after full clearance, immediate placement, and early loading of full-arch fixed bridges.
Fifty-five patients subjected to full clearance and placement of 284 Neoss implants (Bimodal™ and Proactive™, Neoss Ltd, Harrogate, UK) in 29 edentulous maxillae and 26 mandibles for early loading (1 to 3 days) of a provisional full-arch bridge were retrospectively evaluated after 1 to 6 years of loading. Osstell™ measurements (Osstell AB, Göteborg, Sweden) were taken at placement and after 3 to 9 months when the provisional bridge was replaced with a permanent one. Marginal bone levels were measured in intraoral radiographs.
All patients (100%) wore a fixed bridge at the time of finalizing the study. A total of 18 failures (6.3%) were encountered during the follow-up, giving an overall cumulative survival rate of 93.7%. All failures occurred in the maxilla (10.6%), and no implants were lost in the mandible. More Bimodal™ (9.0%) than Proactive™ (4.1%) implants failed. Failing implants showed a significantly lower mean primary stability than successful ones (p = .015). Failed cases showed a significantly lower average ISQ for all implants (p = .015) and a marked decrease to the second registration, while successful cases showed and maintained high ISQs. The average bone loss after 1 year was 0.8 ± 0.5 mm.
Full-arch clearance of severely diseased teeth followed by immediate placement of Neoss implants, early loading with provisional full-arch bridges, and subsequent permanent bridges is a possible treatment modality for partially dentate patients. Caution with this approach is recommended for the maxilla, as opposed to the mandible.
对患牙进行全牙弓间隙处理并植入种植体支持的修复体是部分牙列缺损患者修复重建的一种解决方案。
回顾性评估全牙弓固定桥全牙弓间隙处理、即刻植入及早期加载后的治疗效果。
回顾性评估55例患者，这些患者在29例无牙上颌骨和26例无牙下颌骨中进行了全牙弓间隙处理并植入284颗Neoss种植体（Bimodal™和Proactive™，Neoss有限公司，英国哈罗盖特），以便对临时全牙弓桥进行早期加载（1至3天），加载1至6年后进行评估。在植入时以及3至9个月后（此时用永久性桥替换临时桥）进行Osstell™测量（瑞典哥德堡Osstell AB公司）。在口腔内X光片中测量边缘骨水平。
在研究结束时，所有患者（100%）都佩戴了固定桥。随访期间共出现18例失败（6.3%），总体累积生存率为93.7%。所有失败均发生在上颌骨（10.6%），下颌骨中无种植体丢失。Bimodal™种植体（9.0%）的失败率高于Proactive™种植体（4.1%）。失败的种植体显示出的平均初始稳定性明显低于成功的种植体（p = 0.015）。失败病例中所有种植体的平均植入稳定性商数（ISQ）明显较低（p = 0.015），且第二次记录时明显下降，而成功病例则显示并维持了较高的ISQ。1年后的平均骨吸收为0.8±0.5毫米。
对严重病变牙齿进行全牙弓间隙处理，随后即刻植入Neoss种植体，用临时全牙弓桥进行早期加载，以及随后安装永久性桥，是部分牙列缺损患者的一种可行治疗方式。与下颌骨相比，对上颌骨采用这种方法时建议谨慎。
