Goldstein Center for Esthetic and Implant Dentistry, Department of Restorative Sciences, Augusta University, Augusta, GA, USA.
Private Practice Rome, Rome, Italy.
Clin Oral Implants Res. 2021 Dec;32(12):1397-1410. doi: 10.1111/clr.13839. Epub 2021 Sep 8.
To evaluate clinical, radiological performance of novel digital workflow integrating dynamic navigation to streamline in one-visit single-implant immediate loading in aesthetic zone.
Consecutive patients requiring one single-implant in aesthetic zone of both jaws were treated between May and September 2017. Primary outcomes were implant and prosthetic success rates, surgical and prosthetic complications, marginal bone loss (MBL), final pink aesthetic score (PES-f), and implant stability quotient (ISQ-f). Secondary outcomes were ISQ-0 and PES-0 at implant positioning and PES-p at definitive prosthesis placement. Potential effect of jaw (maxilla vs mandible), biotype (thin vs thick), type of incision (flap vs flapless), and implant site (healed vs. post-extractive) on the primary outcomes (MBL, PES-f, and ISQ-f) was evaluated through a multivariable analysis.
Fifty-two implants were placed (follow-up 18.6, 15-20 months). One post-extractive implant failed. No other surgical, biological complications occurred, accounting for 98.10% cumulative success rate (CSR). No definitive prostheses failed. Mean MBL was -0.63 ± 0.25 mm (-1.69 to -0.06). PES-f was 12.34 ± 1.41 (9-14). ISQ-f was 78.1 ± 3.2 (70-84). Age had significantly negative effect on MBL and PES-f (p = .0058 and p = .0052). No other variables significantly affected primary outcomes.
Within study limitations, investigated digital workflow integrating dynamic navigation was reliable for single-implant immediate loading in aesthetic zone in one visit. No statistically significant difference was found for MBL, PES-f, and ISQ-f, considering type of incision (flap vs. flapless), implant site (healed vs post-extractive), jaw (maxilla vs. mandible), and biotype (thick vs. thin). Live-tracked dynamic navigation may have contributed to improve operator clinical performance regardless of implant site characteristics. Further investigations are needed to confirm positive outcomes.
评估将动态导航整合到新型数字化工作流程中以简化单牙种植即刻负重的临床和影像学表现。
2017 年 5 月至 9 月，连续治疗了 52 例需要在上下颌美学区植入单个种植体的患者。主要结果为种植体和修复体的成功率、手术和修复体并发症、边缘骨吸收（MBL）、最终粉色美学评分（PES-f）和种植体稳定性指数（ISQ-f）。次要结果为种植体定位时的 ISQ-0 和 PES-0 以及最终修复体放置时的 PES-p。通过多变量分析评估了颌骨（上颌骨与下颌骨）、生物型（薄型与厚型）、切口类型（有瓣与无瓣）和种植体部位（愈合与拔牙后）对主要结果（MBL、PES-f 和 ISQ-f）的潜在影响。
共植入 52 枚种植体（随访时间 18.6 个月，15-20 个月）。1 枚拔牙后种植体失败。无其他手术、生物学并发症，累积成功率（CSR）为 98.10%。无最终修复体失败。平均 MBL 为-0.63±0.25mm（-1.69 至-0.06）。PES-f 为 12.34±1.41（9-14）。ISQ-f 为 78.1±3.2（70-84）。年龄对 MBL 和 PES-f 有显著负影响（p=0.0058 和 p=0.0052）。其他变量对主要结果无显著影响。
在所研究的局限性内，研究中所涉及的整合动态导航的新型数字化工作流程在一次就诊中即可实现美学区单牙种植即刻负重，其结果可靠。考虑切口类型（有瓣与无瓣）、种植体部位（愈合与拔牙后）、颌骨（上颌骨与下颌骨）和生物型（薄型与厚型），MBL、PES-f 和 ISQ-f 无统计学差异。无论种植体部位特征如何，实时跟踪动态导航可能有助于提高操作人员的临床效果。需要进一步研究以确认这些积极结果。
