Toljanic Joseph A, Ekstrand Karl, Baer Russell A, Thor Andreas
Int J Oral Maxillofac Implants. 2016 Sep-Oct;31(5):1164-70. doi: 10.11607/jomi.4364.
Successful immediate loading of implants in the edentulous maxilla has been previously reported. The purpose of this 5-year prospective study was to further assess long-term outcomes following immediate loading of implants in the edentulous maxilla with fixed provisional restorations without the use of bone augmentation procedures.
Subjects with edentulous maxillary arches each received six implants placed in native bone without augmentation. Where insufficient posterior bone volume existed, angled implant placement was employed. Fixed provisional restorations were delivered within 24 hours of implant placement. Implant placement locations, insertion torque values, and implant dimensions were recorded. Definitive fixed prostheses were placed within 24 weeks following implantation. Baseline implant site marginal bone levels were measured using periapical radiographs. Baseline peri-implant plaque and bleeding scores were obtained. Subjects were examined 6 months after implant placement and then annually for 5 years with follow-up periapical radiographs and plaque/bleeding scores obtained.
Fifty-one subjects received a total of 306 implants. Forty subjects with 232 implants returned for the final follow-up appointment representing a 5-year implant survival proportion of 93% with a mean marginal bone loss of 0.44 ± 1.25 mm for this group. Thirty-nine of these 40 subjects continued to function with fixed restorations with the remaining subject functioning with a non-implant-retained removable prosthesis.
Within the limitations of this study, predictable long-term implant rehabilitation outcomes were demonstrated for the edentulous maxilla using an immediate loading protocol without bone augmentation.
先前已有关于在上颌无牙区成功即刻种植修复的报道。本项为期5年的前瞻性研究旨在进一步评估在上颌无牙区即刻种植并采用固定临时修复体且不使用骨增量手术的长期效果。
上颌无牙弓的受试者每人植入6枚种植体于天然骨内,未进行骨增量。在后部骨量不足的情况下,采用倾斜种植体植入。种植体植入后24小时内戴入固定临时修复体。记录种植体植入位置、植入扭矩值和种植体尺寸。种植后24周内安装最终的固定修复体。使用根尖片测量种植体植入部位的基线边缘骨水平。获取种植体周围菌斑和出血的基线评分。种植体植入后6个月对受试者进行检查,之后每年检查1次,共5年,期间拍摄随访根尖片并获取菌斑/出血评分。
51名受试者共植入306枚种植体。40名受试者植入232枚种植体后返回进行最终随访,该组5年种植体存留率为93%,平均边缘骨吸收为0.44±1.25mm。这40名受试者中有39名继续使用固定修复体,其余1名使用非种植支持的可摘义齿。
在本研究的局限性范围内,采用即刻种植方案且不进行骨增量的上颌无牙区种植修复可获得可预测的长期效果。