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一体式钛加工修复体即刻种植与加载情况下假体设计对牙种植效果的影响

The Influence of Prosthesis Design on the Outcomes of Tooth Implants Immediately Placed and Loaded by Means of One-Piece Titanium Machined Restoration.

作者信息

Toti Paolo, Marconcini Simone, Enrica Giammarinaro, Pedretti Giorgio, Barone Antonio, Covani Ugo

机构信息

1   Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy.

2   AMT MEDICAL SRL Headquarters, Gordona, Italy.

出版信息

J Oral Implantol. 2018 Apr;44(2):87-93. doi: 10.1563/aaid-joi-D-17-00152. Epub 2017 Nov 28.

Abstract

Our purpose was to evaluate the occurrence of complications and the degree of bone loss in a cohort of patients treated with fixed prostheses supported by immediately loaded dental implants. The primary aim was to compare partial versus full-arch fixed dental prostheses. We then tested the effect of sinus lifting. In the present retrospective cohort study, the patients had their implants restored with fixed dental prostheses supported by dental implants positioned in the posterior maxilla and mandible. When necessary, the maxillary sinuses were grafted with particulate autogenous bone. Patients were then ranked according to the following predictors: length of prosthesis, crown-to-implant ratio, number of crowns to number of implants ratio, and presence of sinus lifting. Outcomes were evaluated for up to 2 years regarding the peri-implant marginal bone loss and implant/prosthesis survival rates. Fifty-eight subjects (209 implants) were rehabilitated with 25 fixed full-arch prostheses and 33 partial fixed dental implant bridges (16 supported by implants placed in grafted sinus). The mean marginal bone loss for implants supporting partial fixed dental prostheses amounted to 0.81 mm, whereas that for implants within the group of full-arch fixed dental prostheses was 1.21 mm; the comparison of the levels in the 2 groups showed a significant difference ( P = .0055). A statistically significant difference ( P = .0006) was found between the bone loss around maxillary implants (1.53 mm) and the bone loss around mandibular implants (1.10 mm). Two implants and 4 prostheses failed; 2-year survival rates of partial and of full-arch fixed dental prostheses, respectively, were 94.1% and 96%. Bone loss in full-arch prostheses appeared to be higher than in that of partial prosthesis. Implant-supported prostheses in the maxillae exhibited a bone loss higher than that registered in mandibles.

摘要

我们的目的是评估一组接受即刻负重牙种植体支持的固定修复患者的并发症发生率和骨吸收程度。主要目的是比较部分牙弓与全牙弓固定义齿。然后我们测试了上颌窦提升的效果。在这项回顾性队列研究中,患者的种植体采用位于上颌骨和下颌骨后部的牙种植体支持的固定义齿进行修复。必要时,用上颌窦自体颗粒骨进行植骨。然后根据以下预测因素对患者进行排序:义齿长度、冠根比、冠数与种植体数之比以及上颌窦提升的情况。对种植体周围边缘骨吸收和种植体/义齿生存率进行了长达2年的评估。58名受试者(209颗种植体)接受了25副全牙弓固定义齿和33副部分固定牙种植体桥修复(16副由植入植骨上颌窦的种植体支持)。支持部分固定义齿的种植体平均边缘骨吸收为0.81mm,而全牙弓固定义齿组种植体的平均边缘骨吸收为1.21mm;两组水平比较显示差异有统计学意义(P = 0.0055)。在上颌种植体周围的骨吸收(1.53mm)和下颌种植体周围的骨吸收(1.10mm)之间发现有统计学意义的差异(P = 0.0006)。2颗种植体和4副义齿失败;部分和全牙弓固定义齿的2年生存率分别为94.1%和96%。全牙弓义齿的骨吸收似乎高于部分义齿。上颌骨中种植体支持的义齿骨吸收高于下颌骨。

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