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短(6 毫米)牙种植体与窦底提升和较长(≥10 毫米)牙种植体的放置:一项 3 年随访的随机对照试验。

Short (6-mm) dental implants versus sinus floor elevation and placement of longer (≥10-mm) dental implants: a randomized controlled trial with a 3-year follow-up.

机构信息

Department of Oral and Maxillofacial Surgery, Lithuanian University of Health Science, Kaunas, Lithuania.

Department of Clinical and Experimental Medicine, University of Varese, Varese, Italy.

出版信息

Clin Oral Implants Res. 2017 Sep;28(9):1097-1107. doi: 10.1111/clr.12923. Epub 2016 Jul 12.

Abstract

OBJECTIVES

To investigate whether short (6-mm) dental implants could be an alternative to sinus floor elevation (SFE) and placement of longer (≥10-mm) implants in the posterior maxilla.

MATERIALS AND METHODS

Over a 3-year period, all patients presenting with partial edentulism in the posterior maxilla were considered for inclusion in this randomized controlled trial. Patients were randomly chosen either to receive short (6-mm) implants (test group [TG]) or to undergo SFE with simultaneous placement of standard-length (≥10-mm) implants (control group [CG]). SFE was performed using the lateral technique. In both groups, tapered implants (AnyRidge, MegaGen, Gyeongbuk, South Korea) were placed. All implants were loaded after 4 months of healing. At each annual follow-up session, clinical and radiographic parameters were assessed. Primary outcomes were implant survival, stability (measured with the implant stability quotient [ISQ]), marginal bone loss (MBL), and complications; secondary outcomes were patient satisfaction and treatment time and cost.

RESULTS

Thirty-three patients were assigned to the TG and 20 to the CG. Forty-five implants were inserted in each group. At 3 years, implant survival rates were 100% and 95.0% for the TG and CG, respectively; this difference was not statistically significant (P = 0.38). The mean ISQ values of the TG and CG did not differ at placement (68.2 vs. 67.8, P = 0.1), at delivery of the final restoration (69.5 vs. 69.4, P = 0.9), and after 1 year (71.0 vs. 71.5, P = 0.1); at 3 years, the CG had a significantly higher mean ISQ than the TG (72.4 vs. 71.6, P = 0.004). Mean MBL was significantly higher in the CG than in the TG, both at 1 year (0.14 mm vs. 0.21 mm, P = 0.006) and at 3 years (0.20 mm vs. 0.27 mm, P = 0.01). A few complications were reported. Surgical time and cost were significantly higher in the CG than in the TG (P < 0.0001). Patient satisfaction was high in both groups.

CONCLUSIONS

In this randomized controlled trial, results for short (6-mm) implants were similar to those for longer (≥10-mm) implants in augmented bone. Short implants might be preferable to SFE, because the treatment is faster and less expensive. Long-term randomized controlled trials are required to confirm these results.

摘要

目的

研究短(6 毫米)种植体是否可以替代鼻窦底提升(SFE)并在上颌后牙区植入更长(≥10 毫米)的种植体。

材料与方法

在 3 年期间,所有上颌后牙部分缺失的患者均被纳入本随机对照试验。患者随机选择接受短(6 毫米)种植体(试验组 [TG])或 SFE 联合标准长度(≥10 毫米)种植体同时植入(对照组 [CG])。SFE 采用外侧技术进行。两组均植入锥形种植体(AnyRidge、MegaGen、Gyeongbuk、韩国)。所有种植体在愈合 4 个月后加载。在每年的随访中,评估临床和影像学参数。主要结局是种植体存活率、稳定性(用种植体稳定性指数 [ISQ] 测量)、边缘骨丧失(MBL)和并发症;次要结局是患者满意度和治疗时间及成本。

结果

33 名患者被分配到 TG 组,20 名患者被分配到 CG 组。每组植入 45 个种植体。3 年后,TG 和 CG 的种植体存活率分别为 100%和 95.0%;差异无统计学意义(P=0.38)。TG 和 CG 的平均 ISQ 值在植入时(68.2 与 67.8,P=0.1)、最终修复体交付时(69.5 与 69.4,P=0.9)和 1 年后(71.0 与 71.5,P=0.1)无差异;3 年后,CG 的平均 ISQ 明显高于 TG(72.4 与 71.6,P=0.004)。CG 的平均 MBL 明显高于 TG,1 年时(0.14 毫米与 0.21 毫米,P=0.006)和 3 年时(0.20 毫米与 0.27 毫米,P=0.01)。报告了一些并发症。CG 的手术时间和成本明显高于 TG(P<0.0001)。两组患者满意度均较高。

结论

在本随机对照试验中,短(6 毫米)种植体在上颌后牙区骨增量中的结果与长(≥10 毫米)种植体相似。短种植体可能优于 SFE,因为治疗速度更快,成本更低。需要进行长期的随机对照试验来证实这些结果。

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