Research Fellow, Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark; Resident, Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Private practice, Turin, Italy.
Consultant, Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark; Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
J Prosthet Dent. 2020 May;123(5):717-723. doi: 10.1016/j.prosdent.2019.04.024. Epub 2019 Aug 20.
The replacement of 2 adjacent missing teeth remains a clinical challenge. Among the different treatment options, the use of a single implant to support a 2-unit cantilever fixed dental prosthesis (FDP) has been proposed in situations of limited mesiodistal space, even though the evidence for its use is low.
The purpose of this retrospective comparative case series was to evaluate hard and soft peri-implant tissues in patients with 2 adjacent missing teeth in the anterior area (incisors or canines) rehabilitated with implant-supported 2-unit cantilevers or single crowns on adjacent implants.
Twenty-three from a cohort of 34 patients rehabilitated with 2-implant systems between September 2006 and November 2015 with 2-unit cantilever FDPs (test group) (n=16) or 2 adjacent dental implants supporting single crowns (control group) (n=7) were available for follow-up. At the baseline and follow-up examinations, the implant survival rate, peri-implant probing pocket depth, marginal bone level (MBL), as well as papilla scores and prosthetic outcomes from the Copenhagen Index Score were recorded and evaluated.
One implant in the control group was lost during the observation period, leading to an overall implant survival rate of 97%. Mean peri-implant probing depths were low (≤5 mm) in both the groups. Stable marginal bone levels were detected around adjacent implants and around implants supporting cantilevers. Medium to high esthetic scores were obtained in most patients. Papilla index scores were high (score 1 and 2) in both the groups. Finally, no technical complications were recorded.
The use of a single-implant-supported 2-unit cantilever FDP in anterior sites is a valid treatment option compared with 2 adjacent implants, especially when the available mesiodistal space is limited.
替换两颗相邻缺失的牙齿仍然是一个临床挑战。在不同的治疗选择中，即使使用证据有限，在牙间距离有限的情况下，也提出使用单个种植体来支撑 2 单位的悬臂式固定义齿（FDP）。
本回顾性病例系列研究的目的是评估在前牙区（切牙或尖牙）中，用种植体支持的 2 单位悬臂式 FDP 或相邻种植体上的 2 个单冠修复 2 颗相邻缺失的牙齿后，硬组织和软组织的种植体周围情况。
从 2006 年 9 月至 2015 年 11 月期间，用 2 个种植体系统修复的 34 名患者中的 23 名（共 23 名患者，其中 16 名患者使用 2 单位悬臂式 FDP 作为实验组，7 名患者使用 2 个相邻种植体支持单冠作为对照组）可进行随访。在基线和随访检查时，记录和评估种植体的存活率、种植体周围探诊深度、边缘骨水平（MBL）、以及来自哥本哈根指数评分的乳头评分和修复体结果。
对照组中有一个种植体在观察期间丢失，导致总体种植体存活率为 97%。两组的种植体周围探诊深度均较低（≤5mm）。相邻种植体和支撑悬臂的种植体周围检测到稳定的边缘骨水平。大多数患者获得了中到高的美学评分。两组的乳头指数评分均较高（评分 1 和 2）。最后，没有记录到技术并发症。
在牙间距离有限的情况下，在前牙区使用单个种植体支撑的 2 单位悬臂式 FDP 是一种有效的治疗选择，与 2 个相邻种植体相比具有优势。
