Eskan Mehmet Akif, Uzel Gokhan, Yilmaz Seyit
Clinic Eska, Polat Tower, Fulya Mah., Yesilcimen Sk. Sisli, Istanbul, Turkey.
College of Dental Medicine, Department of Periodontics, NOVA Southeastern University, Fort Lauderdale, FL, USA.
Int J Implant Dent. 2020 Nov 23;6(1):77. doi: 10.1186/s40729-020-00271-1.
Immediate function has become an accepted treatment modality for fixed restorations in completely edentulous jaws. It is known that implant microtopography (surface) may enhance osseointegration, while implant macrotopography (macrodesign) plays an important role in primary stability in the patient requiring an immediate loading. The aim of this retrospective study was to evaluate the clinical and radiographic outcomes of the edentulous subjects treated with narrow and/or regular diameter, which placed and loaded immediately.
Forty-two consecutive patients received 171 implants, including regular and narrow diameter implants (NDIs). Each jaw, 19 mandibles and 24 maxillae, was treated with a fixed-full arch prosthesis according to the Straumann® Pro Arch concept. The majority (95%) of the restorations were supported by four implants, of which the posterior two implants were tilted. A provisional functional acrylic prosthesis was delivered on the day of surgery. All patients were followed up to 55 months. Cumulative survival rate was determined using Kaplan-Meier analysis. Radiological measurement of marginal bone level was performed.
The overall follow-up time for survival rate was up to 55 months. Four implants (3 implants in maxilla, 1 implant in mandible) were lost, resulting in an overall cumulative implant survival rate of 97.7%. Implant survival rate in the axial and tilted implants was not statistically significant. The mean of interproximal marginal bone loss was 0.15 mm after 24 months. Good soft tissue health was observed in almost 99% of patients. The final prosthesis survival rate was 100%.
The results of this retrospective pilot study indicated that total edentulous patients requiring an immediate implant placement and loading can be successfully treated with this implant design. The improved mechanical properties of these implants might give a more conservative treatment option for the jaws showing a severe horizontal alveolar bone resorption.
即刻功能已成为全口无牙颌固定修复的一种公认治疗方式。已知种植体微观形貌（表面）可增强骨结合，而种植体宏观形貌（宏观设计）在需要即刻负重的患者的初期稳定性中起重要作用。本回顾性研究的目的是评估即刻植入并负重的窄直径和/或常规直径种植体治疗无牙颌患者的临床和影像学结果。
42例连续患者接受了171枚种植体，包括常规直径种植体和窄直径种植体（NDIs）。根据Straumann® Pro Arch理念，对每侧颌骨，即19例下颌骨和24例上颌骨，采用固定全牙弓修复体进行治疗。大多数（95%）修复体由4枚种植体支持，其中后两枚种植体为倾斜种植体。在手术当天交付临时功能性丙烯酸修复体。所有患者随访至55个月。采用Kaplan-Meier分析确定累积生存率。进行边缘骨水平的影像学测量。
生存率的总体随访时间长达55个月。4枚种植体（上颌3枚，下颌1枚）丢失，总体种植体累积生存率为97.7%。轴向种植体和倾斜种植体的生存率无统计学差异。24个月后，邻间边缘骨丢失的平均值为0.15mm。几乎99%的患者观察到良好的软组织健康状况。最终修复体生存率为100%。
这项回顾性初步研究的结果表明，需要即刻种植和负重的全口无牙颌患者可以通过这种种植体设计成功治疗。这些种植体改善的力学性能可能为显示严重水平牙槽骨吸收的颌骨提供更保守的治疗选择。
