Peñarrocha-Oltra David, Covani Ugo, Peñarrocha Miguel, Peñarrocha-Diago Maria
Int J Oral Maxillofac Implants. 2015 Mar-Apr;30(2):427-34. doi: 10.11607/jomi.3534.
To compare immediate and conventional loading protocols for fixed full-arch mandibular prostheses supported by immediate and nonimmediate implants.
A prospective controlled nonrandomized study with 12 months of follow-up included patients requiring fixed full-arch rehabilitations supported by immediate and nonimmediate implants. Eighteen patients were treated with conventional loading (control group), and 18 were treated with immediate loading (test group). Each patient received four to six implants; implants with insertion torque < 35 Ncm were excluded from the study and loaded conventionally. The following variables were assessed: implant success, biologic and prosthetic complications, success of the immediately loaded provisional prostheses, and marginal bone loss. Statistical analysis was performed with nonparametric tests (chi-square, Mann-Whitney, Kruskal-Wallis) with an alpha value of .05.
Thirty-six patients consecutively enrolled in the study. Two control group patients failing to attend control visits and 12 implants that did not achieve an insertion torque of 35 Ncm were excluded. The final sample consisted of 34 patients and 183 implants (98 test and 85 control implants). Implant success rates were 99.0% (test) and 97.6% (control). Within the test group, success rates for immediate and nonimmediate implants were 100% and 97.6%, respectively. Differences were not statistically significant. All immediately loaded prostheses were successful. Five provisional fixed prostheses presented with loosened screws; all control group patients reported discomfort with the provisional denture. Average bone loss was 0.71 mm (standard deviation 0.25 mm) in the test group and 0.60 mm (standard deviation 0.28 mm) in the control group.
No significant differences were seen in implant success and peri-implant marginal bone loss between immediate and conventional loading of mandibular fixed full-arch prostheses supported by immediate and nonimmediate implants. Biologic and prosthetic complications were rare, and all immediately loaded provisional fixed prostheses performed successfully.
比较即刻种植和非即刻种植支持的固定全下颌义齿的即刻加载和传统加载方案。
一项前瞻性对照非随机研究，随访12个月，纳入需要即刻种植和非即刻种植支持的固定全牙弓修复的患者。18例患者接受传统加载（对照组），18例患者接受即刻加载（试验组）。每位患者植入4至6枚种植体；植入扭矩<35 Ncm的种植体被排除在研究之外并采用传统方式加载。评估以下变量：种植体成功率、生物学和修复并发症、即刻加载临时义齿的成功率以及边缘骨丢失。采用非参数检验（卡方检验、曼-惠特尼检验、克鲁斯卡尔-沃利斯检验）进行统计分析，α值为0.05。
36例患者连续纳入研究。排除2例未参加对照访视的对照组患者和12枚未达到35 Ncm植入扭矩的种植体。最终样本包括34例患者和183枚种植体（98枚试验组种植体和85枚对照组种植体）。种植体成功率分别为99.0%（试验组）和97.6%（对照组）。在试验组中，即刻种植和非即刻种植的成功率分别为100%和97.6%。差异无统计学意义。所有即刻加载的义齿均成功。5例临时固定义齿出现螺钉松动；所有对照组患者均报告临时义齿不适。试验组平均骨丢失为0.71 mm（标准差0.25 mm），对照组为0.60 mm（标准差0.28 mm）。
即刻种植和非即刻种植支持的下颌固定全牙弓义齿的即刻加载和传统加载在种植体成功率和种植体周围边缘骨丢失方面无显著差异。生物学和修复并发症罕见，所有即刻加载的临时固定义齿均成功。
