Seemann Rudolf, Wagner Florian, Marincola Mauro, Ewers Rolf
Professor, University Clinic of Cranio- and Maxillofacial Surgery, Medical University of Vienna, Vienna, Austria.
Resident, University Clinic of Cranio- and Maxillofacial Surgery, Medical University of Vienna, Vienna, Austria.
J Oral Maxillofac Surg. 2018 May;76(5):956-962. doi: 10.1016/j.joms.2017.11.043. Epub 2017 Dec 12.
The aim of this study was to evaluate the midterm outcomes of fixed, full-arch, fiber-reinforced resin bridges on ultrashort implants in terms of marginal bone loss and overall implant survival.
Patients with severely atrophic mandibles, corresponding to Cawood and Howell class V and class VI, were included in this prospective temporal cohort study. Mesial and distal peri-implant bone levels were measured on panoramic radiographs taken at the time of implant insertion (baseline) and at follow-up visits.
A total of 17 patients with atrophic mandibular jaws with an average follow-up period of 2.9 ± 1.5 years were included. The cumulative 1-, 3-, and 5-year patient-based implant survival rates were 94.1%, and the cumulative implant survival rates were 98.5%. The marginal bone level (MBL) of the mesial implants was 0.0 ± 0.3 mm at the time of loading (n = 33), -0.1 ± 0.3 mm (n = 20) after 1 year, -0.4 ± 0.5 mm (n = 10) after 3 years, and -1.5 ± 1.0 mm (n = 4) after 5 years. The mesial bone level depended significantly on time and insertion depth. The MBL of the distal implants was -0.4 ± 0.4 mm (n = 34) at the time of implantation, -0.4 ± 0.6 mm (n = 20) after 1 year, -0.5 ± 0.5 mm (n = 10) after 3 years, and -2.2 ± 1.7 mm (n = 4) after 5 years. The distal bone level depended significantly on time and insertion depth.
Fixed, full-arch, fiber-reinforced resin bridges retained by 4 ultrashort implants provide a comparatively cost-effective, safe, stable alternative for prosthetic restoration of the severely atrophic mandible. The overall implant survival rate and the MBL after 5 years are equivalent to those of threaded implants of conventional lengths.
本研究旨在评估固定全牙弓纤维增强树脂桥接于超短种植体上的中期效果,包括边缘骨吸收情况和种植体总体存留率。
本前瞻性队列研究纳入了符合Cawood和Howell V类及VI类标准的严重萎缩性下颌骨患者。在种植体植入时(基线)及随访时拍摄全景X线片,测量种植体近中和远中周围的骨水平。
共纳入17例萎缩性下颌骨患者,平均随访时间为2.9±1.5年。基于患者的种植体1年、3年和5年累积存留率为94.1%,种植体累积存留率为98.5%。加载时近中种植体的边缘骨水平(MBL)为0.0±0.3mm(n = 33),1年后为-0.1±0.3mm(n = 20),3年后为-0.4±0.5mm(n = 10),5年后为-1.5±1.0mm(n = 4)。近中骨水平显著依赖于时间和植入深度。植入时远中种植体的MBL为-0.4±0.4mm(n = 34),1年后为-0.4±0.6mm(n = 20),3年后为-0.5±0.5mm(n = 10),5年后为-2.2±1.7mm(n = 4)。远中骨水平也显著依赖于时间和植入深度。
由4枚超短种植体支持的固定全牙弓纤维增强树脂桥为严重萎缩性下颌骨的修复提供了一种相对经济有效、安全稳定的替代方案。5年后的种植体总体存留率和MBL与传统长度的螺纹种植体相当。