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种植体支持的固定义齿修复体带有悬臂延伸的临床和影像学结果。一项至少随访 10 年的回顾性队列研究。

Clinical and radiographic outcomes of implant-supported fixed dental prostheses with cantilever extension. A retrospective cohort study with a follow-up of at least 10 years.

机构信息

Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.

Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark.

出版信息

Clin Oral Implants Res. 2020 Dec;31(12):1243-1252. doi: 10.1111/clr.13672. Epub 2020 Oct 17.

Abstract

AIM

To report the clinical and radiographic outcomes of implant-supported fixed dental prostheses with cantilever extensions (FDPCs) after a function time ≥10 years.

MATERIAL AND METHODS

Patients with FDPCs in posterior areas were clinically and radiographically re-evaluated. Mesial and distal radiographic marginal bone levels (mBLs) from baseline (i.e. delivery of FDPC) to the follow-up examination were calculated and compared between implant surfaces adjacent to and distant from the cantilever extension. Implant survival rate, pocket probing depth (PPD), presence/absence of bleeding on probing (BoP) and presence/absence of mechanical/technical and biological complications were recorded.

RESULTS

Twenty-six patients with 30 FDPCs supported by 60 implants were re-evaluated after a mean loading time of 13.3 ± 2.7 years (range: 10-18.6 years). One diameter-reduced implant carrying a cantilever extension fractured, yielding a patient-based survival rate of 96.2% (95% CI: 0.95/1.0). The mean marginal bone level change was not statistically significantly different from baseline to follow-up (1.2 mm ± 0.9 to 1.6 mm ± 1.7; 95% CI: -0.1/0.9; p > .05). The mean PPD changed statistically significantly from 3.4 mm ± 0.7 to 3.7 mm ± 0.7 (95% CI: 0.04/0.6; p = .02). Loss of retention occurred ≥ 1x in 9 patients (34.6%, 95% CI: 0.44/0.83). At follow-up, peri-implant health was diagnosed in 12 (46.2%), peri-implant mucositis in 7 (26.9%) and peri-implantitis in 7 (26.9%) patients, respectively.

CONCLUSION

Despite a high rate of loss of retention, the use of implant-supported FDPCs in posterior areas represents a reliable long-term treatment option with a high implant survival rate and minimal peri-implant bone level changes irrespective of the location of the cantilever extension.

摘要

目的

报告经过≥10 年功能期后,带有悬臂延伸的种植体支持固定义齿(FDPC)的临床和影像学结果。

材料与方法

对后牙区的 FDPC 患者进行临床和影像学重新评估。从基线(即 FDPC 交付)到随访检查,计算并比较了与悬臂延伸相邻和不相邻的种植体表面的近远中放射线边缘骨水平(mBL)。记录了种植体存活率、探诊深度(PPD)、探诊出血(BoP)的有无以及机械/技术和生物学并发症的有无。

结果

26 名患者的 30 个 FDPC 由 60 个种植体支持,在平均加载时间 13.3±2.7 年后(范围:10-18.6 年)进行了重新评估。一个带有悬臂延伸的直径减小的种植体发生了断裂,导致患者为基础的存活率为 96.2%(95%可信区间:0.95/1.0)。从基线到随访,平均边缘骨水平变化无统计学显著差异(1.2mm±0.9 至 1.6mm±1.7;95%可信区间:-0.1/0.9;p>.05)。PPD 平均值从 3.4mm±0.7 变为 3.7mm±0.7(95%可信区间:0.04/0.6;p=.02),有统计学显著变化。9 名患者(34.6%,95%可信区间:0.44/0.83)出现保留丢失≥1 次。在随访时,12 名患者(46.2%)诊断为种植体周围健康,7 名患者(26.9%)诊断为种植体周围黏膜炎,7 名患者(26.9%)诊断为种植体周围炎。

结论

尽管保留丢失率较高,但在后牙区使用种植体支持的 FDPC 是一种可靠的长期治疗选择,具有较高的种植体存活率和最小的边缘骨水平变化,而与悬臂延伸的位置无关。

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