Woods Brent, Schenberg Michael, Chandu Arun
Oral and Maxillofacial Surgeon, Western Hospital, Footscray, VIC, Australia.
Oral and Maxillofacial Surgeon, Dandenong Hospital, Monash Health, Melbourne; Honorary Senior Lecturer, Department of Surgery, Monash University, Melbourne, VIC, Australia.
J Oral Maxillofac Surg. 2019 Jun;77(6):1156-1164. doi: 10.1016/j.joms.2019.02.007. Epub 2019 Feb 13.
Implant-supported dental prostheses offer numerous benefits for patients after ablative procedures of the head and neck region, including restoration of function, improved self-esteem and body satisfaction, and overall quality of life. Increased experience is emerging with immediate placement of implants at the time of ablative surgery compared with the traditional delayed approach. The authors sought to identify variables affecting survival of osseointegrated dental implants in such patients and to assess the impact of timing of implant insertion (immediate vs delayed) on the time until final prosthesis insertion.
Implant survival was assessed based on different factors: immediate versus delayed implants, benign versus malignant disease, postoperative radiotherapy, smoking status, alcohol status, age, 1- versus 2-stage surgery, hyperbaric oxygen therapy, and implant placement into native bone versus into osseous free flap reconstruction. Time to final prosthesis insertion was compared between immediate and delayed implant placement.
The study included 20 patients who received a total of 102 implants (39 immediate, 63 delayed). There were 7 failed implants (overall survival, 93.14%). There was no statistically relevant difference in implant survival between any of the groups assessed. However, there was a significant decrease in time to final prosthesis insertion for those patients receiving immediate implants compared with those who underwent delayed implant placement (321 days; standard error, 46.5 vs 726 days; standard error, 45 days; P < .0001).
Immediate implant placement is an effective approach to the prosthetic rehabilitation of patients undergoing ablative procedures of the jaws, which shortens time to final prosthesis placement without adversely affecting overall implant survival.
种植体支持的牙修复体为头颈部区域进行切除术后的患者带来诸多益处,包括功能恢复、自尊及身体满意度提升以及总体生活质量改善。与传统的延迟植入方法相比,在切除手术时即刻植入种植体的经验日益增多。作者试图确定影响此类患者中骨结合牙种植体存活的变量,并评估种植体植入时机(即刻与延迟)对直至最终修复体植入的时间的影响。
基于不同因素评估种植体存活情况:即刻与延迟种植体、良性与恶性疾病、术后放疗、吸烟状况、饮酒状况、年龄、一期与二期手术、高压氧治疗以及种植体植入自体骨与骨游离瓣重建部位。比较即刻与延迟种植体植入患者直至最终修复体植入的时间。
该研究纳入20例患者,共植入102枚种植体(39枚即刻植入,63枚延迟植入)。有7枚种植体失败(总体存活率为93.14%)。在评估的任何组之间,种植体存活率无统计学显著差异。然而,与接受延迟种植体植入的患者相比,接受即刻种植体植入的患者直至最终修复体植入的时间显著缩短(321天;标准误,46.5天对726天;标准误,45天;P <.0001)。
即刻种植体植入是颌骨切除术后患者进行修复重建的有效方法,可缩短直至最终修复体植入的时间,且不会对种植体总体存活率产生不利影响。