Zweers J, van Doornik A, Hogendorf E A H, Quirynen M, Van der Weijden G A
Department of Periodontology, ACTA, Amsterdam, The Netherlands.
Clin Oral Implants Res. 2015 Feb;26(2):149-56. doi: 10.1111/clr.12309. Epub 2013 Dec 20.
Narrow-diameter implants (NDIs) are used in severely resorbed mandibles. The reduced implant diameter means a reduction in the total contact surface between the implant and bone. The question arises whether the implant can be sufficiently osseointegrated to withstand loading forces. If not, marginal bone loss can result from overload. The aim of this retrospective study was to compare clinical and radiographic measurements and patient satisfaction of NDIs with those of regular-diameter implants (RDIs) placed in edentulous patients to support an overdenture via either a ball or a locator connection.
Retrospectively over a 7-year period, a total 119 patients fulfilled the inclusion criteria and were selected for this study. The patients received two 3.3- or 4.1-mm-diameter standard titanium implants in the mandible to support an overdenture. At maintenance examinations after 1 and 3 years, clinical peri-implant and prosthetic conditions, marginal bone (MB) and patient satisfaction were investigated.
None of the 238 implants were lost during the 3-year follow-up period. Overall MB loss was statistically higher in the NDI group when compared with the RDI group. At the site level, a greater MB loss was observed at the distal side of both implant types. Implants with a locator showed significantly greater MB loss (0.38 mm) compared with the implants with a ball attachment (0.14 mm) over the two-year evaluation period (P = 0.006). Patient satisfaction significantly favoured the NDI (8.3) and the locator attachment (8.6).
The results suggest that during the first three years after implantation, NDIs were associated with more marginal bone loss compared with RDIs. Regardless of implant diameter, the locator attachment showed more marginal bone loss over time compared with the ball attachment.
窄径种植体(NDIs)用于严重吸收的下颌骨。种植体直径减小意味着种植体与骨之间的总接触面积减小。由此产生的问题是,种植体能否充分骨结合以承受加载力。如果不能,过载可能导致边缘骨丢失。本回顾性研究的目的是比较无牙患者中,用于支持覆盖义齿的窄径种植体(NDIs)与常规直径种植体(RDIs)的临床和影像学测量结果以及患者满意度,这些种植体通过球或定位器连接。
回顾性分析7年间,共有119例患者符合纳入标准并被选入本研究。患者在下颌骨接受两颗直径为3.3或4.1毫米的标准钛种植体以支持覆盖义齿。在1年和3年的维护检查中,调查种植体周围临床和修复情况、边缘骨(MB)以及患者满意度。
在3年随访期内,238颗种植体无一丢失。与RDI组相比,NDI组的总体MB丢失在统计学上更高。在种植位点水平,两种种植体类型的远中侧均观察到更大的MB丢失。在两年评估期内,与球附着种植体(0.14毫米)相比,定位器种植体的MB丢失显著更大(0.38毫米)(P = 0.006)。患者满意度明显倾向于NDI(8.3)和定位器附着(8.6)。
结果表明,在植入后的前三年,与RDIs相比,NDIs与更多的边缘骨丢失相关。无论种植体直径如何,随着时间的推移,定位器附着相比球附着显示出更多的边缘骨丢失。