Tettamanti L, Andrisani C, Bassi M Andreasi, Vinci R, Silvestre-Rangil J, Tagliabue A
Department of Medicine and Surgery, University of Insubria, Varese, Italy.
Private Practice in Matera, Matera, Italy.
Oral Implantol (Rome). 2017 Sep 27;10(2):119-128. doi: 10.11138/orl/2017.10.2.119. eCollection 2017 Apr-Jun.
Nowadays, implant supported prosthetic rehabilitation is a reliable procedure to replace compromised or untreatable teeth. The purpose of this review is to explore the concept of post extractive implant and the indications for clinical practice through an analysis of recent studies in the literature. All the main factors that could influence the outcome of this treatment will also be considered.
Focusing on the extraction-socket healing time, three different implant insertion protocols have been defined: Immediate implant placement (IIP), Early implant placement (EIP), Delayed implant placement (DIP). The entity of bone remodeling can be associated with different factors: three dimensional implant position, presence/absence of platform switching, absence of facial bony wall, inter implant/tooth distance.
All the studies in literature agreed that implant primary stability is the main condition for a successful osseointegration of dental implants. Primary implant stability is influenced by many factors including local bone quality and quantity, implant macro-design, soft tissue conditions and rehabilitation, surgical technique, prosthetic load timing, oral hygiene.
There is insufficient evidence in literature to determine possible advantages or disadvantages of IIP, EIP or DIP. Studies suggest that IIP and EIP may be at higher risks of implant failures and complications than delayed implants; on the other hand the aesthetic outcome might be better when placing implants just after teeth extraction.
如今,种植体支持的修复性康复是替代受损或无法治疗牙齿的可靠方法。本综述的目的是通过分析文献中的最新研究,探讨拔牙后种植体的概念及临床应用指征。同时也将考虑所有可能影响该治疗结果的主要因素。
着眼于拔牙窝愈合时间,定义了三种不同的种植体植入方案:即刻种植(IIP)、早期种植(EIP)、延期种植(DIP)。骨重塑的情况可能与不同因素相关:种植体的三维位置、是否采用平台转换、面部骨壁的有无、种植体间/牙间距离。
文献中的所有研究均认为种植体的初期稳定性是牙种植体成功骨结合的主要条件。种植体初期稳定性受多种因素影响,包括局部骨质量和数量、种植体宏观设计、软组织状况与修复、手术技术、修复体加载时机、口腔卫生。
文献中没有足够的证据来确定即刻种植、早期种植或延期种植可能存在的优势或劣势。研究表明,与延期种植相比,即刻种植和早期种植可能有更高的种植失败和并发症风险;另一方面,拔牙后即刻种植的美学效果可能更好。