Department of Oral and Maxillofacial Surgery, Lithuanian University of Health Science, Kaunas, Lithuania.
Department of Clinical and Experimental Medicine, University of Varese, Varese, Italy.
Clin Oral Implants Res. 2017 Sep;28(9):1097-1107. doi: 10.1111/clr.12923. Epub 2016 Jul 12.
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.
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.
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.
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.
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。
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。
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。
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。