Int J Oral Maxillofac Implants. 2019 September/October;34(5):1161–1168. doi: 10.11607/jomi.7365. Epub 2019 Feb 19.
To evaluate the clinical outcomes of aftermarket computer-aided design/computer-assisted manufacturing (CAD/CAM) titanium abutments supporting splinted prostheses and single crowns in the posterior region.
This study retrospectively evaluated the records of patients who received posterior implant-supported splinted restorations and single crowns supported by aftermarket CAD/CAM titanium abutments. Recall and clinical examination of the patients were performed between January 2017 and February 2018. A logistic regression was conducted to evaluate the influence of variables on the occurrence of complications and success rates. Correlations between the bone-level change and variables were calculated using the Spearman correlation.
One hundred thirty-five patients with 287 implants (86 crowns and 97 splinted prostheses) were recalled and examined clinically and radiographically after a mean observation period of 6.3 ± 1.2 years (range 4.1 to 9 years). Failure of 3 implants led to a survival rate of 99.0%. Complications included 18 (9.8%) ceramic chippings, 15 (8.2%) screw loosenings, 8 (4.4%) decementations, 52 (38.5%) patients with peri-implant mucositis, and 9 (6.7%) patients with peri-implantitis. A significantly higher incidence of ceramic chipping occurred with bruxers (odds ratio [OR] = 3.939, 95% confidence interval [CI] = 1.28-12.09, P < .05). All screw loosenings occurred in single crowns. All decementations were observed in restorations cemented with temporary cement. Marginal bone loss around implants was significantly correlated with smoking (r = -0.155, P < .05). Hypertension was significantly associated with peri-implant mucositis (OR = 4.7, 95% CI = 1.65-13.39, P < .05). The technical success rate was 80.1%. The biologic success rate was 57%. There was no association between the restoration type and the success rates of the restorations.
Using aftermarket CAD/CAM titanium abutments to support posterior restorations yielded comparable survival and success rates after a mean observation period of 6 years. However, in light of the relatively high incidence of screw loosenings, especially in patients receiving single-implant crowns, informing patients of the additional chairside aftercare with this type of treatment option is recommended.
评估售后计算机辅助设计/计算机辅助制造（CAD/CAM）钛基台用于支持后牙区夹板式修复体和单冠的临床效果。
本研究回顾性评估了接受后牙区种植体支持的夹板式修复体和单冠的患者记录，这些修复体由售后 CAD/CAM 钛基台支持。于 2017 年 1 月至 2018 年 2 月间对患者进行召回和临床检查。采用逻辑回归评估变量对并发症发生和成功率的影响。使用 Spearman 相关性分析计算骨水平变化与变量之间的相关性。
共 135 名患者（287 个种植体）纳入研究，平均观察期为 6.3 ± 1.2 年（4.1 至 9 年），并在观察期末进行了临床和影像学复查。3 个种植体失败，成功率为 99.0%。并发症包括 18 个（9.8%）陶瓷崩瓷、15 个（8.2%）螺丝松动、8 个（4.4%）粘结剂脱落、52 个（38.5%）患者出现种植体周围黏膜炎和 9 个（6.7%）患者出现种植体周围炎。磨牙症患者的陶瓷崩瓷发生率显著更高（比值比[OR] = 3.939，95%置信区间[CI] = 1.28-12.09，P <.05）。所有螺丝松动均发生于单冠。所有粘结剂脱落均发生于使用临时粘结剂粘结的修复体。种植体周围边缘骨丧失与吸烟显著相关（r = -0.155，P <.05）。高血压与种植体周围黏膜炎显著相关（OR = 4.7，95%CI = 1.65-13.39，P <.05）。技术成功率为 80.1%，生物学成功率为 57%。修复体类型与修复体成功率之间无相关性。
在平均观察 6 年后，使用售后 CAD/CAM 钛基台支持后牙修复体的生存率和成功率相当。然而，鉴于螺丝松动的发生率相对较高，特别是在接受单牙种植体冠修复的患者中，建议告知患者这种治疗方案需要额外的椅旁维护。
