即刻种植和延期种植：一项前瞻性队列研究，纳入 131 例经黏膜切开无瓣种植体，共植入 131 个不同的拔牙位点，这些位点术前均有不同程度的根管感染。

Immediate Early and Delayed Implants: A 2-Year Prospective Cohort Study of 131 Transmucosal Flapless Implants Placed in Sites With Different Pre-extractive Endodontic Infections.

机构信息

*Full Professor, Department of Biomedical and Neuromotor Sciences, School of Dentistry, University of Bologna, Bologna, Italy. †PhD Student, Department of Biomedical and Neuromotor Sciences, Endodontic Clinical Section, School of Dentistry, University of Bologna, Bologna, Italy; Laboratory of Biomaterials and Oral Pathology, Department of Biomedical and Neuromotor Sciences, School of Dentistry, University of Bologna, Bologna, Italy. ‡PhD, Department of Biomedical and Neuromotor Sciences, Endodontic Clinical Section, School of Dentistry, University of Bologna, Bologna, Italy. §Researcher, Laboratory of Biomaterials and Oral Pathology, Department of Biomedical and Neuromotor Sciences, School of Dentistry, University of Bologna, Bologna, Italy. ¶Professor, Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy. ‖Professor, Laboratory of Biomaterials and Oral Pathology, Department of Biomedical and Neuromotor Sciences, School of Dentistry, University of Bologna, Bologna, Italy.

出版信息

Implant Dent. 2017 Oct;26(5):654-663. doi: 10.1097/ID.0000000000000666.

DOI:10.1097/ID.0000000000000666

PMID:28945667

Abstract

INTRODUCTION

To evaluate clinical outcome of early, immediate, and delayed transmucosal implants placed in patients affected by acute/chronic endodontic lesions.

MATERIALS AND METHODS

Eighty-five consecutive patients received 131 titanium implants with zirconium-oxide blasted surface. Pre-extractive diagnosis represented the main criteria for implant placement timing, following "best treatment" criteria. Implants were placed with flapless transmucosal technique. Hopeless teeth with chronic periapical lesions received atraumatic extraction, and an implant was immediately placed (Immediate Group, n = 29). Teeth with acute periapical lesion/abscess were extracted and implants placed after 8 to 12 weeks (Early Group, n = 29). Implants placed 10- to 12-month after extraction constituted the control group (delayed group, n = 73). Implants were loaded 3 months after insertion with provisional resin crowns and after approximately 15 days with definitive ceramic crowns. Marginal bone loss (MBL) was measured in a single-blind manner on periapical radiographs at 1, 3, 6, 12, and 24 months.

RESULTS

Multilevel analysis described exploring factors associated with MBL. Survival rate was 100%. MBL after 24 months was 0.78 ± 0.70 (95% confidence interval [CI]: 0.20 to -1.37) at immediate, 0.48 ± 0.70 at early (95% CI: -0.006 to -0.961), and 1.02 ± 1.01 (95% CI: 0.61 to -1.43) at delayed groups. Implant groups (immediate/early/delayed) and location (maxillary/mandibular) showed statistically significant results. Early group showed the lowest MBL values. The immediate group demonstrated less MBL than the delayed group.

CONCLUSION

Early implant placement technique preserves periimplant marginal bone level more than immediate and delayed techniques.

摘要

简介

评估早期、即刻和延迟经黏膜植入物在患有急性/慢性根管病变患者中的临床效果。

材料与方法

85 例连续患者共接受了 131 个钛锆酸铈 blasted 表面种植体。术前诊断是决定种植时机的主要标准，遵循“最佳治疗”原则。种植采用无瓣经黏膜技术。有慢性根尖病变的无希望牙齿采用微创拔牙，并立即植入种植体（即刻组，n = 29）。有急性根尖病变/脓肿的牙齿被拔除，8 至 12 周后植入种植体（早期组，n = 29）。拔牙后 10-12 个月植入的种植体为对照组（延迟组，n = 73）。植入后 3 个月用临时树脂冠负载，15 天后用永久陶瓷冠负载。在根尖片上以单盲方式测量边缘骨丧失（MBL），分别在 1、3、6、12 和 24 个月时进行测量。

结果

多水平分析描述了探索与 MBL 相关的因素。存活率为 100%。24 个月时，即刻组 MBL 为 0.78 ± 0.70（95%置信区间[CI]：0.20 至-1.37），早期组为 0.48 ± 0.70（95% CI：-0.006 至-0.961），延迟组为 1.02 ± 1.01（95% CI：0.61 至-1.43）。种植体组（即刻/早期/延迟）和部位（上颌/下颌）有统计学显著差异。早期组 MBL 值最低。即刻组的 MBL 少于延迟组。