Center for Dental Implantology, Duisburg, Germany.
Department of Oral and Maxillofacial Surgery, University of Mainz, Mainz, Germany.
Odontology. 2020 Jan;108(1):133-142. doi: 10.1007/s10266-019-00440-8. Epub 2019 Jul 5.
The objective of the current study was to demonstrate the 6-year clinical and radiological treatment outcomes of the technique performed by immediately loading of three implants (single straight in the mid-line and two tilted distal implants) for the management of total edentulous mandibles and introduce a simple decision matrix for selection of the most appropriate protocol in cases with insufficient length of the interforaminal area. Re-assessments were performed over a total observation period of 6 years after surgery via measurement of bone resorption around implants, bleeding on probing, plaque accumulation, periodontal probing depth, bite force measurements and oral health impact profile. A total of 29 patients (45% women and 55% men) with a mean age of 65 ± 6 years enrolled in the study. 14 patients received an acryl-based bridge as definitive prosthetic restoration and 15 patients received a ceramic-based restoration. Both during the immediate loading phase and during the 6-year follow-up, there was no implantation loss. Regardless of the implant position, all implants showed continuous bone loss over the observation time. The bone loss around dental implants during observation period was only maximum 1.0 ± 1 mm and it remained well within the limits for 'success' according to the 2007 Pisa consensus (< 2 mm). The plaque index showed no significant fluctuations between the implant positions and the individual examination times. The approach described herein might help the surgeon by avoiding unnecessary loss of bone strength, selecting implant sites, and establishing the biomechanical advantage of increased A-P spread for immediate function.
本研究的目的是展示即刻加载 3 个种植体（中线单直种植体和两个远中倾斜种植体）治疗完全无牙下颌骨的 6 年临床和影像学治疗结果，并介绍一种简单的决策矩阵，用于选择在颌间距离不足的情况下最合适的方案。在手术后的总观察期 6 年内，通过测量种植体周围的骨吸收、探诊出血、菌斑积累、牙周探诊深度、咬合力测量和口腔健康影响概况，对所有患者进行了重新评估。共有 29 名患者（45%为女性，55%为男性），平均年龄为 65±6 岁，入组本研究。14 名患者接受丙烯酸基桥作为最终修复体，15 名患者接受陶瓷基修复体。即刻加载阶段和 6 年随访期间均未发生种植体脱落。无论种植体位置如何，所有种植体在观察期间均持续出现骨吸收。在观察期间，种植体周围的骨吸收量最大仅为 1.0±1mm，根据 2007 年比萨共识（<2mm），仍处于“成功”范围内。菌斑指数在种植体位置和个体检查时间之间没有明显波动。本研究中描述的方法可以帮助外科医生避免不必要的骨强度丧失，选择种植体部位，并建立增加 A-P 间距的生物力学优势，以实现即刻功能。
