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牙周病损及治疗后患者拒绝采用骨移植手术治疗而选择牙种植体支持式修复的长期疗效。

Long-Term Outcomes of Tooth-Implant-Supported Rehabilitation of Periodontally Compromised and Treated Patients Refusing Bone Grafting Surgical Therapies.

机构信息

Adjunct Professor, Department of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, Rome, Italy.

Private Prosthodontic Practice, Rome, Italy.

出版信息

Implant Dent. 2019 Dec;28(6):528-536. doi: 10.1097/ID.0000000000000847.

Abstract

OBJECTIVE

To evaluate the long-term incidence of complications in abutment teeth and dental implants in periodontally treated and maintained patients, refusing bone grafting surgical therapies, rehabilitated with full-arch telescopic-retained retrievable prostheses (TRPs) and full-arch fixed prosthesis (FPs), both supported by teeth-implants combination.

MATERIALS AND METHODS

After active periodontal therapy, 18 patients were rehabilitated with full-arch TRPs, whereas 17 patients were rehabilitated with full-arch FPs. Patients were annually evaluated for technical and/or biological failures/complications.

RESULTS

During the 15-year observation period, 6 of 164 (3.6%) implants failed and 19 of 233 teeth were extracted (9.2%) in the TRPs group, whereas 6 of 152 (3.9%) implants failed and 23 of 221 (10.4%) abutment teeth were extracted in the FPs group. Differences in implant failures and abutment teeth loss between the 2 groups were not statistically significant. In both the groups, Cox regressions identified significant difference (P < 0.05) for mean initial bone loss, aggressive periodontitis, and smoking, as factors contributing to tooth loss and implant failures in general.

CONCLUSION

In periodontally treated patients, refusing bone grafting surgical therapies, rehabilitated with full-arch TRPs and full-arch fixed prostheses, both supported by teeth-implants connection, high survival rates can be expected if regular supportive periodontal therapy had been performed.

摘要

目的

评估拒绝接受骨移植手术治疗的牙周治疗和维护患者,使用全口可摘式套筒冠义齿(TRP)和全口固定义齿(FP)修复,两种修复方式均通过牙-种植体联合支持,基牙和种植体的长期并发症发生率。

材料与方法

在积极的牙周治疗后,18 名患者使用全口 TRP 进行修复,17 名患者使用全口 FP 进行修复。每年对患者进行技术和/或生物失败/并发症评估。

结果

在 15 年的观察期内,TRP 组中 6 个种植体(3.6%)失败,19 颗基牙(9.2%)被拔除,FP 组中 6 个种植体(3.9%)失败,23 颗基牙(10.4%)被拔除。两组间种植体失败和基牙丧失的差异无统计学意义。在两组中,Cox 回归分析发现,平均初始骨丢失、侵袭性牙周炎和吸烟均为导致牙齿和种植体失败的重要因素(P < 0.05)。

结论

在牙周治疗的患者中,拒绝接受骨移植手术治疗,使用全口 TRP 和全口固定义齿修复,两种修复方式均通过牙-种植体联合支持,如果定期进行支持性牙周治疗,可以预期获得较高的种植体和基牙存活率。

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