Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center for Dental Medicine, University of Zurich, Zurich, Switzerland.
Private Practice, Grimmzahnaerzte, Horgen, Switzerland.
Clin Oral Implants Res. 2019 Mar;30(3):242-251. doi: 10.1111/clr.13410. Epub 2019 Feb 18.
To compare the radiographic marginal bone levels of implants placed in sites previously augmented with autogenous bone grafts and implants placed in native bone. Secondary outcomes included: implant survival, periodontal/peri-implant parameters as well as short- and long-term patient-reported outcome measures.
The study was designed as a case-control study including 38 patients equally distributed into two groups (previously augmented with autogenous bone blocks [AB] and implants placed in native bone [NB]). In total, 67 implants were placed. Clinical, radiographic and patient-reported outcome measures (PROMs), and complication rates were assessed based on a chart review and at a follow-up examination (≧5 years after implant placement). Nonparametric mixed models were applied for the comparison of the two groups because of the clustered data. The data were analyzed descriptively, and p-values were calculated using nonparametric mixed models to account for the clustered data.
The mean follow-up time was 10.2 years (range 6-13 years; AB) and 8.3 years (range 5-16 years; NB). One implant was lost in group NB (97.5% survival rate) and none in group AB (100%). Following primary augmentation, six major complications (wound dehiscences, acute pulpitis, intra- and extraoral sensitivity disturbances) were observed at the donor sites. At time of implant placement, only minimal complications occurred and only in group NB. Median marginal bone levels at the follow-up were significantly higher in group NB (1.15; Q1: 0.50 mm/Q3: 1.83 mm) than in group AB (1.58; Q1: 1.01 mm/Q3: 2.40 mm; p = 0.0411). Probing depth, bleeding on probing and recession values were similar in both groups. PROMs revealed high visual analog scale values (i.e., high satisfaction) for both procedures.
Dental implants placed in sites augmented with autogenous bone or in native bone revealed healthy peri-implant tissues after 5-16 years. Marginal bone levels were significantly higher for implant placed in native bone. Complications following primary augmentation encompassed every third patient but were mostly transient.
比较在自体骨移植部位植入的种植体和在原生骨部位植入的种植体的放射学边缘骨水平。次要结果包括:种植体存活率、牙周/种植体参数以及短期和长期的患者报告的结果测量。
该研究设计为病例对照研究,包括 38 名患者,平均分为两组(自体骨块增强组 [AB] 和原生骨植入组 [NB])。共植入 67 枚种植体。基于图表回顾和随访检查(植入后≧5 年)评估临床、放射学和患者报告的结果测量(PROM)以及并发症发生率。由于数据是聚类的,因此应用非参数混合模型比较两组。数据进行描述性分析,并使用非参数混合模型计算 p 值,以考虑聚类数据。
平均随访时间为 10.2 年(范围 6-13 年;AB)和 8.3 年(范围 5-16 年;NB)。NB 组有 1 枚种植体丢失(存活率 97.5%),AB 组无种植体丢失(100%)。初次增强后,供区发生 6 例主要并发症(伤口裂开、急性牙髓炎、内外敏感性障碍)。种植时仅在 NB 组发生轻微并发症。随访时 NB 组的边缘骨水平中位数明显高于 AB 组(1.15;Q1:0.50mm/Q3:1.83mm)(1.58;Q1:1.01mm/Q3:2.40mm;p=0.0411)。两组的探诊深度、探诊出血和退缩值相似。两种程序的 PROM 均显示出高视觉模拟量表值(即高满意度)。
在自体骨增强部位或原生骨部位植入的种植体在 5-16 年后显示出健康的种植体周围组织。在原生骨部位植入的种植体的边缘骨水平明显更高。初次增强后的并发症涉及每 3 名患者中的 1 名,但大多是短暂的。