Maló Paulo, Nobre Miguel de Araújo, Lopes Armando, Ferro Ana, Moss Steven
Eur J Oral Implantol. 2014 Autumn;7(3):267-81.
To report retrospectively on the 5-year follow-up results of the rehabilitation of complete edentulous atrophied maxillae, using extra-maxillary zygomatic implants alone or in combination with conventional implants.
This retrospective report includes an initial cohort of 39 patients (30 women and 9 men), with a mean age of 53 years, followed for 5 years. The patients were rehabilitated with 39 fixed prostheses and 169 implants (92 zygomatic implants inserted extra-maxillary and 77 conventional dental implants). A provisional prosthesis was manufactured and attached via multiunit abutments secured to the implants on the same day as implant placement. According to patient desires and each clinical situation, either an acrylic resin, a metal-acrylic or metal-ceramic final prosthesis was inserted approximately 6 months after implant placement. Outcome measures were: prosthesis success; implant success; complications; probing pocket depths; marginal bleeding; and marginal bone levels (only for conventional implants). Data were analysed with descriptive statistics.
Two patients died after 8 and 30 months of follow-up due to causes unrelated to their oral rehabilitations, and 5 patients dropped out of the study. No prosthesis was lost; one zygomatic implant was removed after 46 months of follow-up, giving cumulative success rates of 97% and 98.8% (patient and implant related, respectively). Twelve complications occurred in 12 patients: 5 sinus infections in 5 patients, all with a previous history of sinusitis and whose sinus membrane was disrupted during surgery; one oroantral communication (leading to removal of the implant), 2 all acrylic resin prostheses fractures, 1 ceramic crown fracture (on a metal-ceramic prosthesis); and 3 screw loosenings. Bleeding on probing was recorded in 6 patients (13 implants). Probing pocket depths >4 mm were present in 13 patients (23 implants) at 5 years of follow-up. The average (standard deviation) marginal bone loss on conventional implants was 1.16 mm (0.77 mm) in those 9 patients having the intraoral radiographs.
The long term outcome (5 years) of rehabilitations performed on patients with completely edentulous, severely atrophic maxillae supported by immediately loaded zygomatic implants alone, or in combination with conventional implants, is satisfactory.
回顾性报告单纯使用上颌外颧骨种植体或联合传统种植体修复上颌完全无牙萎缩的5年随访结果。
本回顾性报告纳入了39例患者（30例女性和9例男性）的初始队列，平均年龄53岁，随访5年。患者接受了39个固定修复体和169颗种植体修复（92颗上颌外颧骨种植体和77颗传统牙种植体）。在种植体植入当天制作临时修复体，并通过固定在种植体上的多单位基台进行连接。根据患者意愿和具体临床情况，在种植体植入后约6个月植入丙烯酸树脂、金属-丙烯酸或金属-陶瓷最终修复体。观察指标包括：修复体成功率；种植体成功率；并发症；探诊袋深度；边缘出血；边缘骨水平（仅针对传统种植体）。采用描述性统计方法分析数据。
2例患者在随访8个月和30个月后因与口腔修复无关的原因死亡，5例患者退出研究。无修复体脱落；1颗颧骨种植体在随访46个月后取出，患者和种植体相关的累积成功率分别为97%和98.8%。12例患者出现12种并发症：5例患者发生鼻窦感染，均有鼻窦炎病史且手术中鼻窦黏膜受损；1例口鼻瘘（导致种植体取出），2例全丙烯酸树脂修复体骨折，1例金属-陶瓷修复体的陶瓷冠折裂；3例螺钉松动。6例患者（13颗种植体）探诊时有出血。随访5年时，13例患者（23颗种植体）探诊袋深度>4 mm。9例有口腔X光片的患者中，传统种植体的平均（标准差）边缘骨吸收为1.16 mm（0.77 mm）。
对于完全无牙、严重萎缩上颌骨患者，单纯使用即刻负重的颧骨种植体或联合传统种植体进行修复的长期（5年）效果令人满意。
