de Moraes Paulo H, Olate Sergio, Lauria Andrezza, Asprino Luciana, de Moraes Márcio, de Albergaria-Barbosa José Ricardo
Division of Oral and Maxillofacial Surgery, State University of Campinas Brazil.
Department of Oral and Maxillofacial Surgery, Universidad de La FronteraChile; Center for Biomedical Research, Universidad Autónoma de ChileChile.
Int J Clin Exp Med. 2015 Oct 15;8(10):19282-9. eCollection 2015.
The aim of this research was to ascertain the survival of implants installed in the atrophic maxillae of patients treated with or without autogenous bone graft at 8 to 10 years of follow-up. A retrospective study was conducted using clinical and imaging analysis. 42 adult patients were selected, treated with osseointegrated implants in a fixed maxillary prosthesis model with suprastructure using 6 to 8 implants; of these, 22 underwent reconstruction with a bone graft taken from the anterior iliac crest and 20 were treated without any type of bone graft. The sequence of removal, installation and management of the grafts followed routine patterns, and the implant installation and prosthesis preparation also followed parameters established in previous publications. Variables of implant survival, stage of loss and bone stability of the implants were analyzed with the Wilcoxon signed-rank test, considering a value of P<0.05 to obtain statistical significance. After 8 to 10 years of follow-up the 306 implants installed in the 42 patients were evaluated. 162 implants were in the bone graft group, where 8.0% of implants were lost in the pre-loading stage, 3.7% in the post-loading stage and 88.7% had complete survival. In the group without bone graft, 6.17% were lost in the pre-loading stage, 1.85% in the post-loading stage and 90.97% had complete survival. There was no significant difference in the survival of the implants between the two groups (P=0.082). Cervical bone loss between the groups showed no significant differences either (P=0.241). The implants in grafted maxillae with cases of severe maxillary atrophy are just as efficient as implants installed in maxillae without bone graft.
本研究的目的是确定在接受或未接受自体骨移植治疗的患者的萎缩性上颌骨中植入物在8至10年随访期后的存留情况。采用临床和影像学分析进行了一项回顾性研究。选择了42例成年患者，在使用6至8枚种植体的固定上颌修复体模型中接受骨结合种植体治疗；其中，22例采用取自髂前嵴的骨移植进行重建，20例未接受任何类型的骨移植治疗。移植物的取出、植入和处理顺序遵循常规模式，种植体植入和修复体制备也遵循先前出版物中确立的参数。采用Wilcoxon符号秩检验分析种植体存留、缺失阶段和种植体骨稳定性等变量，以P<0.05为有统计学意义。在8至10年的随访后，对42例患者中植入的306枚种植体进行了评估。骨移植组有162枚种植体，其中8.0%的种植体在加载前阶段丢失，3.7%在加载后阶段丢失，88.7%完全存留。在无骨移植组中，6.17%在加载前阶段丢失，1.85%在加载后阶段丢失，90.97%完全存留。两组种植体的存留情况无显著差异（P=0.082）。两组之间的颈部骨吸收也无显著差异（P=0.241）。在严重上颌萎缩病例的植骨上颌骨中的种植体与未进行骨移植的上颌骨中植入的种植体同样有效。
