Rieder Dominik, Eggert Jochen, Krafft Tim, Weber Hans-Peter, Wichmann Manfred G, Heckmann Siegfried M
School of Dental Medicine, University of Erlangen-Nuremberg, Erlangen, Germany.
Private Practice, Weiden, Germany.
Clin Oral Implants Res. 2016 Feb;27(2):e80-6. doi: 10.1111/clr.12539. Epub 2014 Dec 12.
The objective of this randomized clinical trial was to investigate the influence of the time of implant placement (immediate vs. early) and the time of restoration (immediate vs. early) on esthetic outcome in maxillary anterior single implants.
Forty-eight patients with a single failing incisor in the maxilla and a natural contralateral site were randomly distributed into four groups. Treatment variations affected the time of implant placement (immediate or early) as well as the time of restoration (immediate or early) - in detail, group 1a with immediate implant placement and immediate temporary restoration, group 1b with immediate implant placement and early restoration, group 2a with early implant placement and immediate temporary restoration, and group 2b with early implant placement and early restoration. All patients received the final prosthetic restoration 10-12 weeks after implant placement. Standardized photographs were taken eight months after tooth extraction. Five competent observers analyzed the esthetic outcome according to the PES after Fürhauser. For statistical analysis, the Kruskal-Wallis test and Dunn's post hoc test were applied. Interobserver reliability was evaluated by Krippendorff's alpha.
The overall scores of the four treatment groups revealed PES values of 8.47 (SD 2.08, group 1a), 7.93 (SD 3.21, group 1b), 6.62 (SD 3.24, group 2a), and 8.10 (SD 3.25, group 2b). The differences between groups 2a and 1a and between groups 2a and 2b were statistically significant (P = 0.015 and P = 0.047). The single parameter analysis displayed a certain range of fluctuation and heterogeneity.
Immediate implant placement and restoration appear to be a viable alternative to early implant placement if an experienced surgeon is entrusted with the implantation procedure.
本随机临床试验的目的是研究种植体植入时间（即刻种植与早期种植）和修复时间（即刻修复与早期修复）对上颌前牙单颗种植体美学效果的影响。
48例上颌单颗切牙缺失且对侧有天然牙的患者被随机分为四组。治疗差异影响种植体植入时间（即刻或早期）以及修复时间（即刻或早期）——具体而言，1a组为即刻种植并即刻临时修复，1b组为即刻种植并早期修复，2a组为早期种植并即刻临时修复，2b组为早期种植并早期修复。所有患者在种植体植入后10 - 12周接受最终修复体修复。拔牙后8个月拍摄标准化照片。5名专业观察者根据Fürhauser的PES标准分析美学效果。统计分析采用Kruskal - Wallis检验和Dunn事后检验。观察者间信度通过Krippendorff's alpha进行评估。
四个治疗组的总体评分显示，PES值分别为8.47（标准差2.08，1a组）、7.93（标准差3.21，1b组）、6.62（标准差3.24，2a组）和8.10（标准差3.25，2b组）。2a组与1a组之间以及2a组与2b组之间的差异具有统计学意义（P = 0.015和P = 0.047）。单参数分析显示出一定范围的波动和异质性。
如果委托经验丰富的外科医生进行种植手术，即刻种植和修复似乎是早期种植的可行替代方案。
