de Araújo Nobre Miguel, Lopes Armando, Antunes Elsa
Research, Development and Education Department, Maló Clinic, 1600-042 Lisboa, Portugal.
Oral Surgery Department, Maló Clinic, 1600-042 Lisboa, Portugal.
J Clin Med. 2022 Mar 31;11(7):1939. doi: 10.3390/jcm11071939.
There is a need for a long-term evidence of implants placed in challenging conditions. The aim of this study was to investigate the outcome of full-arch rehabilitations with the All-on-4 concept for implants inserted with dehiscence or fenestrations.
This retrospective cohort study included 123 patients (dehiscence, = 87 patients; fenestrations, = 28 patients; both conditions, = 8 patients), with a total of 192 implants in immediate function presenting dehiscence ( = 150), fenestrations ( = 40), or both conditions ( = 2). Primary outcome measures were cumulative implant survival (CSurR) and success (CSucR) rates. Secondary outcome measures were prosthetic survival, marginal bone loss, and incidence of biological complications.
CSurRs were 94.1% (overall), 95.6% (dehiscence), and 88.1% (fenestrations) at 10 years using the patient as the unit of analysis. Smoking affected implant failure significantly ( = 0.019). Implant-level CSurRs and CSucRs at 10 years were 96.2% and 93.5% (overall), 97.2% and 94.6% (dehiscence), and 90.0% and 87.6% (fenestrations), respectively. Average bone resorption at 5 and 10 years was 1.22 mm and 1.53 mm, respectively. Biological complications occurred in 18 patients ( = 18 implants).
Implants inserted with dehiscence or fenestrations demonstrate good long-term outcomes with overall high success and survival rates and low average marginal bone resorption, despite an inferior outcome in implants with fenestrations and smoking's negative effect.
需要长期证据来证明在具有挑战性的条件下植入种植体的效果。本研究的目的是调查采用All-on-4概念对伴有骨开裂或骨开窗植入的种植体进行全牙弓修复的结果。
这项回顾性队列研究纳入了123例患者（骨开裂87例；骨开窗28例；两种情况均有8例），共有192枚即刻功能种植体，存在骨开裂（150枚）、骨开窗（40枚）或两种情况均有（2枚）。主要观察指标为种植体累积留存率（CSurR）和成功率（CSucR）。次要观察指标为修复体留存率、边缘骨吸收和生物并发症发生率。
以患者为分析单位，10年时的CSurR分别为94.1%（总体）、95.6%（骨开裂）和88.1%（骨开窗）。吸烟对种植体失败有显著影响（P = 0.019）。10年时种植体水平的CSurR和CSucR分别为96.2%和93.5%（总体）、97.2%和94.6%（骨开裂）以及90.0%和87.6%（骨开窗）。5年和10年时的平均骨吸收分别为1.22 mm和1.53 mm。18例患者（18枚种植体）发生了生物并发症。
伴有骨开裂或骨开窗植入的种植体显示出良好的长期效果，总体成功率和留存率高，平均边缘骨吸收低，尽管骨开窗种植体的效果较差且吸烟有负面影响。
