Kutkut Ahmad, Rezk Mohamed, Zephyr Dominique, Dawson Dolphus, Frazer Robert, Al-Sabbagh Mohanad
Division of Restorative Dentistry, College of Dentistry, University of Kentucky, Lexington, Ky.
Division of Periodontology, College of Dentistry, University of Kentucky, Lexington, Ky.
J Oral Implantol. 2019 Oct;45(5):378-389. doi: 10.1563/aaid-joi-D-18-00202. Epub 2019 Aug 7.
This clinical study aimed to clinically and radiographically compare the implant survival rate and peri-implant tissue response between immediate and delayed loading protocols for unsplinted implant retained mandibular overdentures. Twenty patients were enrolled to participate in this study. Each subject was randomly assigned to 1 of 2 treatment groups: test group patients' implants (n = 10), which were immediately loaded, and control group patients' implants (n = 10), which were conventionally loaded. Locator abutments were torqued to 15 Ncm at delivery. Attachments were picked up intraorally immediately after implant placement for the test group and at 3 months for the control group, and 3-lb retention inserts were placed. Marginal bone levels based on cone beam computed tomography fixed reference points were recorded at baseline and 12 months. Modified plaque index, gingival index, and implant stability quotients were recorded at baseline, 3 months, and 12 months. After 12 months, implant survival rate was 100% in both groups. Marginal bone levels, keratinized mucosa, modified plaque index, and gingival index were significantly different among the groups at 3- and 12-month intervals, whereas no significant differences were found in implant stability quotients between the groups. The fact that implant survival rate was 100% in both treatment groups suggests that, within the limitations of this study, immediate loading protocol for unsplinted implant retained mandibular complete overdenture is as predictable, safe, and successful as the delayed loading protocol. Implementing the immediate loading protocol for mandibular implant retained overdentures could shorten treatment time, which could lead to better patient's satisfaction.
本临床研究旨在通过临床和影像学方法,比较无夹板种植体支持的下颌覆盖义齿即刻加载和延迟加载方案之间的种植体存活率及种植体周围组织反应。20名患者参与了本研究。每位受试者被随机分配至2个治疗组中的1组:试验组患者的种植体(n = 10)即刻加载,对照组患者的种植体(n = 10)采用传统加载。定位基台在交付时扭矩设定为15 Ncm。试验组在种植体植入后立即在口内取模,对照组在3个月后取模,并放置3磅的固位嵌体。基于锥形束计算机断层扫描固定参考点记录基线和12个月时的边缘骨水平。在基线、3个月和12个月时记录改良菌斑指数、牙龈指数和种植体稳定性商数。12个月后,两组种植体存活率均为100%。在3个月和12个月时,两组间边缘骨水平、角化黏膜、改良菌斑指数和牙龈指数存在显著差异,而两组间种植体稳定性商数无显著差异。两个治疗组的种植体存活率均为100%这一事实表明,在本研究的局限性范围内,无夹板种植体支持的下颌全口覆盖义齿即刻加载方案与延迟加载方案一样具有可预测性、安全性和成功率。对下颌种植体支持的覆盖义齿实施即刻加载方案可缩短治疗时间,从而提高患者满意度。