Raes Stefanie, Cosyn Jan, Noyelle Anabel, Raes Filiep, De Bruyn Hugo
Int J Periodontics Restorative Dent. 2018 May/Jun;38(3):337-345. doi: 10.11607/prd.3478.
Recent systematic reviews point to the scarcity of single implants followed up longer than 5 years, and the incidence of biologic/technical complications is underreported. This prospective follow-up study documents 8- to 10-year clinical outcomes of immediately restored single implants in extraction sockets (immediate implant treatment [IIT]) and healed bone (conventional implant treatment [CIT]). Patients received a single, chemically modified, moderately rough titanium implant and a provisional crown on the day of surgery in the anterior maxilla (second premolar to second premolar). Provisional crowns were replaced by permanent crowns after 10 weeks. Implant survival, complications, crestal bone changes, plaque score, probing depth, and bleeding on probing were regularly recorded up to 10 years of follow-up. Of 16 patients who underwent IIT, 11 could be evaluated after 8 years. Of the 23 patients who received an implant in healed bone, 18 were finally evaluated. One implant failed in the IIT group at 12 weeks; all implants survived in the CIT group; 38% of the patients experienced at least one complication; 10% had one or more biologic complications, whereas 31% experienced one or more technical complications. There were no significant changes in crestal bone level from 1 to ≥ 8 years of follow-up for either group or between IIT and CIT at any time point (P ≥ .129). Only 6.9% (2 of 29) implants demonstrated progressive bone loss > 2 mm combined with pockets ≥ 6 mm. Immediately restored single implants in extraction sockets and healed ridges demonstrate good long-term outcomes in terms of implant survival, crestal bone loss, and peri-implant health. However, biologic and especially technical complications are common.
近期的系统评价指出，随访时间超过5年的单颗种植体数量稀少，且生物/技术并发症的发生率报告不足。这项前瞻性随访研究记录了在上颌前牙区拔牙窝即刻种植（即刻种植治疗[IIT]）和愈合骨内种植（传统种植治疗[CIT]）的单颗种植体8至10年的临床结局。患者在手术当天于上颌前牙区（第二前磨牙至第二前磨牙）接受单颗经化学改性、表面适度粗糙的钛种植体及临时冠修复。10周后临时冠更换为永久冠。在长达10年的随访期间，定期记录种植体存留情况、并发症、牙槽嵴顶骨变化、菌斑评分、探诊深度及探诊出血情况。接受IIT的16例患者中，11例在8年后可进行评估。接受愈合骨内种植的23例患者中，最终18例可进行评估。IIT组有1颗种植体在12周时失败；CIT组所有种植体均存活；38%的患者至少发生1次并发症；10%发生1次或多次生物并发症，而31%发生1次或多次技术并发症。两组在随访1年至≥8年期间，牙槽嵴顶骨水平均无显著变化，且在任何时间点IIT组与CIT组之间也无显著差异（P≥0.129）。仅6.9%（29颗中的2颗）种植体出现骨吸收进展>2 mm且伴有牙周袋≥6 mm。拔牙窝和愈合牙槽嵴内即刻修复的单颗种植体在种植体存留、牙槽嵴顶骨吸收及种植体周围健康方面均显示出良好的长期效果。然而，生物并发症尤其是技术并发症较为常见。
