Queridinha Bruno Mt, Almeida Ricardo F, Felino António, de Araújo Nobre Miguel, Maló Paulo
Int J Oral Maxillofac Implants. 2016 Jul-Aug;31(4):891-9. doi: 10.11607/jomi.4324.
The purpose of this study was to compare the outcome of fixed partial prostheses in the posterior maxilla with two axially placed implants or one implant placed distally tilted and one axially placed implant following an immediate loading protocol.
A sample of 60 patients was divided into two groups-group 1: 30 patients rehabilitated with one axially placed implant and one implant placed distally tilted in the posterior maxilla; group 2: 30 patients rehabilitated with two axially placed implants in the posterior maxilla. Outcome measures were implant survival based on function, marginal bone resorption, and the incidence of mechanical and biologic complications at 5 years; inferential statistics were used to analyze the intergroup and intragroup differences. The level of significance was set at 5%.
No significant differences were found between both groups in survival, complications, or marginal bone resorption. One axially placed implant was lost at 58 months in group 1, rendering a cumulative survival estimate at 5 years of 96.7% and 98.3% in group 1 and the total sample, respectively (P = .317). Mechanical complications occurred in 16 patients (26.7%; n = 8 patients in each group; [P > .999]), consisting of fractures in the provisional prosthesis (n = 8 patients), chipped ceramics of the definitive prosthesis (n = 2 patients), loosening of prosthetic components (n = 5 patients), and fracture of an attachment screw (n = 1 patient). Biologic complications occurred in 5 patients (8.3%; group 1 = 4 patients; group 2 = 1 patient; [P = .161]), consisting of peri-implant pathology. The mean ± SD marginal bone loss was 2.02 ± 0.36 mm and 1.90 ± 0.69 mm for groups 1 and 2, respectively (P = .235). In group 1, the mean ± SD marginal bone loss was 1.92 ± 0.48 mm and 2.11 ± 0.44 mm for the implant placed distally tilted and axially placed implant, respectively; the difference was significant (P < .001).
Within the limitations of this study, the use of implants placed distally tilted together with axially placed implants or two axially placed implants in the fixed partial rehabilitation of the posterior maxilla are viable treatment alternatives.
本研究的目的是比较在上颌后牙区采用两颗轴向种植体或一颗远中倾斜种植体与一颗轴向种植体并采用即刻负重方案的固定局部义齿修复效果。
选取60例患者作为样本，分为两组。第1组：30例患者在上颌后牙区采用一颗轴向种植体和一颗远中倾斜种植体进行修复；第2组：30例患者在上颌后牙区采用两颗轴向种植体进行修复。观察指标为基于功能的种植体存留率、边缘骨吸收情况以及5年时机械和生物并发症的发生率；采用推断性统计分析组间和组内差异。显著性水平设定为5%。
两组在存留率、并发症或边缘骨吸收方面均未发现显著差异。第1组在58个月时一颗轴向种植体脱落，第1组和总样本在5年时的累积存留率估计分别为96.7%和98.3%（P = 0.317）。16例患者（26.7%；每组8例患者；[P > 0.999]）发生机械并发症，包括临时义齿折断（8例患者）、最终义齿陶瓷崩裂（2例患者）、修复部件松动（5例患者）以及附着螺钉折断（1例患者）。5例患者（8.3%；第1组4例患者；第2组1例患者；[P = 0.161]）发生生物并发症，包括种植体周围病变。第1组和第2组的平均±标准差边缘骨吸收分别为2.02±0.36 mm和1.90±0.69 mm（P = 0.235）。在第1组中，远中倾斜种植体和轴向种植体的平均±标准差边缘骨吸收分别为1.92±0.48 mm和2.11±0.44 mm；差异具有显著性（P < 0.001）。
在本研究的局限性范围内，在上颌后牙区固定局部义齿修复中，采用远中倾斜种植体与轴向种植体联合或两颗轴向种植体是可行的治疗选择。
