Noelken Robert, Oberhansl Fabienne, Kunkel Martin, Wagner Wilfried
Private Practice for Oral Surgery, Lindau/Lake Constance, Germany.
Department of Oral and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg University of Mainz, Mainz, Germany.
Clin Oral Implants Res. 2016 Jun;27(6):744-9. doi: 10.1111/clr.12651. Epub 2015 Aug 24.
A sloped shoulder might improve the congruence between extraction socket and dental implant and may add to a better circumferential support of the peri-implant structures. Therefore, this study evaluates the 3-year clinical outcome (survival and success rates, marginal bone levels, and Pink Esthetic Score (PES)) of immediately inserted and provisionalized OsseoSpeed(™) Profile implants in the anterior maxilla.
Twenty-one implants were inserted in 16 patients. All implants were immediately placed into extraction sites with and without facial bone deficiencies. A flapless procedure was utilized, and the implants were provisionalized immediately. Facial gaps were grafted with autogenous bone chips from the mandibular ramus. Implant survival and success, the interproximal bone levels, the thickness of the facial bony wall, and the PES were evaluated.
After a mean follow-up period of 43 months, 19 implants were still in function. One patient with 1 implant did not follow the study protocol (dropout) and 1 implant was lost at 10 weeks. Interproximal marginal bone levels measured -0.2 ± 0.4 mm (range, -1.0-0.4 mm) apical to the implant shoulder. The mean PES ratings were 11.9 ± 1.4 (range, 8-14) at the final examination.
Clinical and radiographic results provide evidence that sloped implants can preserve the marginal bone circumferentially and are able to maintain soft tissue esthetics when inserted and provisionalized immediately, even in the presence of facial bony wall defects.
倾斜肩部可能会改善拔牙窝与牙种植体之间的贴合度,并可能增强种植体周围结构的圆周支撑。因此,本研究评估了在前上颌立即植入并临时固定的OsseoSpeed(™) Profile种植体的3年临床结果(生存率和成功率、边缘骨水平和粉色美学评分(PES))。
16例患者共植入21枚种植体。所有种植体均立即植入有或无面部骨缺损的拔牙位点。采用不翻瓣手术,种植体立即进行临时固定。面部间隙用来自下颌支的自体骨屑移植。评估种植体的生存率和成功率、邻间骨水平、面部骨壁厚度和PES。
平均随访43个月后,19枚种植体仍在发挥功能。1例植入1枚种植体的患者未遵循研究方案(失访),1枚种植体在10周时丢失。种植体肩部根尖处的邻间边缘骨水平测量值为-0.2±0.4mm(范围为-1.0至0.4mm)。最终检查时的平均PES评分为11.9±1.4(范围为8至14)。
临床和影像学结果表明,即使存在面部骨壁缺损,倾斜种植体在立即植入并临时固定时,也能在圆周方向上保留边缘骨,并能够维持软组织美学效果。