Han Chang-Hun, Mangano Francesco, Mortellaro Carmen, Park Kwang-Bum
*EasyPlant Dental Clinic, Seo-Gu, Gwangju, South Korea†Department of Surgical and Morphological Science, Dental School, University of Insubria, Varese‡Department of Health Science, University of Eastern Piedmont, Novara, Italy§Mir Dental Hospital, Jung-Gu, Daegu, South Korea.
J Craniofac Surg. 2016 Jul;27(5):1220-7. doi: 10.1097/SCS.0000000000002756.
The aim of the present study was to compare the survival, stability, and complications of immediately loaded implants placed in postextraction sockets and healed sites.
Over a 2-year period, all patients presenting with partial or complete edentulism of the maxilla and/or mandible (healed site group, at least 4 months of healing after tooth extraction) or in need of replacement of nonrecoverable failing teeth (postextraction group) were considered for inclusion in this study. Tapered implants featuring a nanostructured calcium-incorporated surface were placed and loaded immediately. The prosthetic restorations comprised single crowns, fixed partial dentures, and fixed full arches. Primary outcomes were implant survival, stability, and complications. Implant stability was assessed at placement and at each follow-up evaluation (1 week, 3 months, and 1 year after placement): implants with an insertion torque (IT) <45 N·cm and/or with an implant stability quotient (ISQ) <70 were considered failed for immediate loading. A statistical analysis was performed.
Thirty implants were placed in postextraction sockets of 17 patients, and 32 implants were placed in healed sites of 22 patients. There were no statistically significant differences in ISQ values between the 2 groups, at each assessment. In total, 60 implants (96.8%) had an IT ≥45 and an ISQ ≥70 at placement and at each follow-up control: all these implants were successfully loaded. Only 2 implants (1 in a postextraction socket and 1 in a healed site, 3.2%) could not achieve an IT ≥45 N·cm and/or an ISQ ≥70 at placement or over time: accordingly, these were considered failed for stability, as they could not be subjected to immediate loading. One of these 2 implants, in a healed site of a posterior maxilla, had to be removed, yielding an overall 1-year implant survival rate of 98.4%. No complications were reported. No significant differences were reported between the 2 groups with respect to implant failures and complications.
Immediately loaded implants placed in postextraction sockets and healed sites had similar high survival and stability, with no reported complications. Further long-term studies on larger samples of patients are needed to confirm these results.
本研究旨在比较即刻种植于拔牙窝和愈合位点的种植体的存活率、稳定性及并发症情况。
在2年期间,所有上颌和/或下颌出现部分或全部牙列缺失的患者(愈合位点组,拔牙后至少愈合4个月)或需要替换无法保留的患牙的患者(拔牙后组)均被纳入本研究。植入具有纳米结构含钙表面的锥形种植体并即刻加载。修复体包括单冠、固定局部义齿和固定全牙弓。主要观察指标为种植体存活率、稳定性及并发症。在种植体植入时及每次随访评估(植入后1周、3个月和1年)时评估种植体稳定性:植入扭矩(IT)<45 N·cm和/或种植体稳定性商数(ISQ)<70的种植体被视为即刻加载失败。进行了统计学分析。
在17例患者的拔牙窝中植入了30枚种植体,在22例患者的愈合位点植入了32枚种植体。在每次评估时,两组间的ISQ值无统计学显著差异。总共60枚种植体(96.8%)在植入时及每次随访检查时IT≥45且ISQ≥70:所有这些种植体均成功加载。仅2枚种植体(1枚在拔牙窝,1枚在愈合位点,3.2%)在植入时或随访期间无法达到IT≥45 N·cm和/或ISQ≥70:因此,这些种植体因稳定性问题被视为失败,因为它们无法进行即刻加载。这2枚种植体中的1枚位于上颌后部的愈合位点,不得不被取出,1年种植体总存活率为98.4%。未报告并发症。两组在种植体失败和并发症方面未报告有显著差异。
即刻种植于拔牙窝和愈合位点的种植体具有相似的高存活率和稳定性,且未报告并发症。需要对更多患者样本进行进一步的长期研究以证实这些结果。