Department of Dental Medicine and Oral Health, Division of Oral Surgery and Orthodontics, Medical University of Graz, Austria.
Department of Dental Medicine and Oral Health, Division of Prosthodontics, Restorative Dentistry, Periodontology and Implantology, Medical University of Graz, Austria.
Clin Implant Dent Relat Res. 2017 Oct;19(5):895-900. doi: 10.1111/cid.12513. Epub 2017 Jun 27.
Implant-retained overdentures have become a standard option for the prosthetic treatment of the edentulous mandible in the elderly.
This prospective study aimed to compare immediate and conventional loading of four interforaminal implants supporting a Locator-retained mandibular overdenture in elderly patients regarding implant survival, implant stability, and implant-related complications.
The study population comprised 20 completely edentulous patients (11 males) aged 60 years and older with severe mandible resorption. Each patient received four interforaminal implants (Neoss Ltd., Harrogate, UK). Following randomization, implants were loaded either immediately after dental implant surgery or 3 months after implant placement with the Locator-abutment system. At follow-up visits 3, 6 12, 24, and 36 months after loading, implant stability was evaluated with Periotest and Ostell.
Twenty patients received 80 implants. In eight patients, 32 implants were loaded immediately. Two patients had to be switched from the immediate to the conventional loading group due to insufficient primary stability (≤30 Ncm). Implant survival was similar in both groups after 36 months. No implant was lost. Decreasing Periotest, and accordingly, increasing Ostell measurements indicated adequate osseointegration in both groups. The course of treatment was not significantly different in the two groups. There were comparable incidences of postoperative complaints like swelling, hematoma, or wound dehiscence, as well as need for prosthetic treatment due to abutment loosening or occlusal discrepancies. Incidence of pressure marks and number of patient visits were significantly higher in the conventional loading group.
With sufficient primary stability, immediate loading of four interforaminal implants in the edentulous mandible might be the preferential choice in the elderly, reducing total treatment time, and number of patient visits.
种植体支持的覆盖义齿已成为老年人无牙颌下颌骨修复的标准选择。
本前瞻性研究旨在比较 4 颗种植体支持Locator 固位的下颌覆盖义齿即刻和常规负载对老年患者种植体存活率、种植体稳定性和种植体相关并发症的影响。
研究人群包括 20 名年龄在 60 岁及以上、下颌严重吸收的完全无牙患者（11 名男性）。每位患者均植入 4 颗种植体（Neoss Ltd.，英国哈罗盖特）。随机分组后，种植体在牙种植手术后即刻或植入后 3 个月用Locator 基台加载。在加载后 3、6、12、24 和 36 个月的随访中，用 Periotest 和 Ostell 评估种植体稳定性。
20 名患者共植入 80 颗种植体。其中 32 颗种植体即刻负载于 8 名患者中。由于初始稳定性不足（≤30 Ncm），2 名患者从即刻负载组转为常规负载组。36 个月后两组种植体存活率相似，无种植体脱落。两组的 Periotest 值逐渐降低，Ostell 值逐渐升高，表明均有良好的骨整合。两组的治疗过程无显著差异。两组术后并发症（如肿胀、血肿或伤口裂开）和因基台松动或咬合差异需要修复治疗的发生率相似。常规负载组的压痕发生率和就诊次数明显更高。
在老年人中，只要有足够的初始稳定性，即刻负载 4 颗下颌无牙区种植体可能是首选，可缩短总治疗时间和就诊次数。
