Peñarrocha-Oltra David, Covani Ugo, Peñarrocha-Diago Miguel, Peñarrocha-Diago Maria
Cirugía Bucal, Clínicas Odontológicas, Gascó Oliag 1, 46021 Valencia, Spain,
Med Oral Patol Oral Cir Bucal. 2014 Sep 1;19(5):e512-7. doi: 10.4317/medoral.19664.
To critically review the evidence-based literature on immediate loading of implants with fixed full-arch prostheses in the maxilla to determine 1) currently recommended performance criteria and 2) the outcomes that can be expected with this procedure.
Studies from 2001 to 2011 on immediate loading with fixed full-arch maxillary prostheses were reviewed. Clinical series with at least 5 patients and 12 months of follow-up were included. Case reports, studies with missing data and repeatedly published studies were excluded. In each study the following was assessed: type of study, implant type, number of patients, number of implants, number of implants per patient, use of post-extraction implants, minimum implant length and diameter, type of prosthesis, time until loading, implant survival rate, prosthesis survival rate, marginal bone loss, complications and mean follow-up time. Criteria for patient selection, implant primary stability and bone regeneration were also studied.
Thirteen studies were included, reporting a total of 2484 immediately loaded implants in 365 patients. Currently accepted performance criteria regarding patient and implant selection, and surgical and prosthetic procedures were deduced from the reviewed articles. Implant survival rates went from 87.5% to 100%, prosthesis survival rates from 93.8% to 100% and radiographic marginal bone loss from 0.8 mm to 1.6 mm.No intraoperative complications and only minor prosthetic complications were reported.
The literature on immediate loading with fixed full-arch prostheses in the maxilla shows that a successful outcome can be expected if adequate criteria are used to evaluate the patient, choose the implant and perform the surgical and prosthetic treatment. Lack of homogeneity within studies limits the relevance of the conclusions that can be drawn, and more controlled randomized studies are necessary to enable comparison between the immediate and the conventional loading procedures.
批判性地回顾关于在上颌使用固定全牙弓修复体即刻加载种植体的循证文献，以确定：1）当前推荐的性能标准；2）该手术预期的结果。
回顾了2001年至2011年关于上颌固定全牙弓修复体即刻加载的研究。纳入至少有5例患者且随访12个月的临床系列研究。排除病例报告、有缺失数据的研究以及重复发表的研究。在每项研究中评估以下内容：研究类型、种植体类型、患者数量、种植体数量、每位患者的种植体数量、拔牙后种植体的使用情况、种植体的最小长度和直径、修复体类型、加载前的时间、种植体存活率、修复体存活率、边缘骨丢失、并发症以及平均随访时间。还研究了患者选择标准、种植体初始稳定性和骨再生情况。
纳入13项研究，共报道了365例患者的2484颗即刻加载种植体。从综述文章中推导出当前关于患者和种植体选择以及手术和修复程序的公认性能标准。种植体存活率从87.5%到100%，修复体存活率从93.8%到100%，影像学边缘骨丢失从0.8毫米到1.6毫米。未报告术中并发症，仅报告了轻微的修复并发症。
关于上颌固定全牙弓修复体即刻加载的文献表明，如果使用适当的标准评估患者、选择种植体并进行手术和修复治疗，有望获得成功的结果。研究之间缺乏同质性限制了可得出结论的相关性，需要更多对照随机研究来比较即刻加载和传统加载程序。
