Department of Implantology, Peking University School and Hospital of Stomatology Beijing, China.
Clin Implant Dent Relat Res. 2019 Jun;21(3):473-481. doi: 10.1111/cid.12784. Epub 2019 May 8.
To assess the clinical outcomes of implant-supported full-arch immediate prosthesis over 6 months of functions and analyze the risk factors of prosthetic complications.
This retrospective cohort study included patients who were treated with implant-supported full-arch restoration under immediate loading protocol between April 2008 and June 2016, and who wore the immediate prosthesis for more than 6 months. Medical charts were reviewed for the patients' general information, implant information, prosthetic information, and details of any prosthetic complications. Prosthetic complications were classified as follows: class I, prosthesis loosening; class II, fewer than three artificial teeth fractured; class III, three or more artificial teeth fractured; and class IV, resin base fractures. A cox proportional hazards ratio model was adopted to analyze the potential risk factors for class IV complications.
A total of 114 patients (mean age, 56.73 ± 10.19 years) and 144 prostheses were included. The average wearing time for the immediate prosthesis was 21.9 months, and 62 (54.39%) patients experienced prosthetic complications, 30 of whom suffered from complications more than once. The most common complications were class II complications (12.3%) during the first 6 months of functioning and class IV complications (28.1%) during the entire function period. Class II complications were more common in the anterior region, while class IV complications occurred more often in the posterior region. The multivariable Cox proportional hazards regression model showed that a prosthesis in the maxilla (HR = 3.37, P = .001) and fiber reinforcement (HR = 0.39, P = .021) were significantly related to class IV complications.
Implant-supported full-arch immediate prosthesis functioning over 6 months have a high prevalence of prosthetic complications. Fiber-reinforcement could reduce the prevalence of class IV complications when acrylic immediate prosthesis functioned longer than 6 months. Avoiding using the anterior teeth of the immediate prosthesis to tear pliable but strong food may prevent tooth fracture.
评估种植体支持的全颌即刻义齿在 6 个月功能期内的临床效果,并分析修复体并发症的风险因素。
本回顾性队列研究纳入了 2008 年 4 月至 2016 年 6 月期间接受种植体支持的全颌即刻修复并采用即刻负重方案、且戴用即刻义齿超过 6 个月的患者。回顾病历以获取患者的一般信息、种植体信息、修复体信息以及任何修复体并发症的详细信息。修复体并发症分为以下几类:I 类,修复体松动;II 类,少于 3 颗人工牙折裂;III 类,3 颗或 3 颗以上人工牙折裂;IV 类,树脂基托折裂。采用 Cox 比例风险比模型分析 IV 类并发症的潜在风险因素。
共纳入 114 名患者(平均年龄 56.73±10.19 岁)和 144 件修复体。即刻义齿的平均佩戴时间为 21.9 个月,62 名(54.39%)患者发生修复体并发症,其中 30 名患者发生过一次以上并发症。在功能的前 6 个月最常见的并发症是 II 类并发症(12.3%),在整个功能期内最常见的并发症是 IV 类并发症(28.1%)。II 类并发症在前牙区更为常见,而 IV 类并发症在后牙区更为常见。多变量 Cox 比例风险回归模型显示,上颌(HR=3.37,P=.001)和纤维增强(HR=0.39,P=.021)的修复体与 IV 类并发症显著相关。
种植体支持的全颌即刻义齿在 6 个月以上的功能期内具有较高的修复体并发症发生率。纤维增强在丙烯酸即刻义齿功能超过 6 个月时可降低 IV 类并发症的发生率。避免使用即刻义齿的前牙撕咬柔韧但坚韧的食物可能预防牙折。