Will Michael J, Drago Carl
Private Practice, Will Surgical Arts, Rockville, MD.
Private Practice, Greenbrook Dental Group, Brookfield, WI.
J Prosthodont. 2023 Feb;32(2):116-124. doi: 10.1111/jopr.13534. Epub 2022 Jun 2.
Innovations in macroimplant design, specifically ultrawide implants 7.0 mm or greater in diameter, have allowed immediate molar replacement. This is a retrospective study assessing the survival rates of ultrawide diameter implants (7.0, 8.0, 9.0 mm) immediately placed into molar extraction sockets. Implants were followed up to 144 months postplacement.
A retrospective study was conducted of all patients treated in a private surgical practice between January 1, 2008 and December 31, 2020, who received ultrawide dental implants (7.0, 8,0, 9.0 mm.) placed immediately into molar extraction sockets. Wide diameter healing abutments were placed on all implants at the time of surgery. Abutments and crown restorations were fabricated after at least 4 months of unloaded healing. Patient age, sex, implant location and implant diameters were examined for survival. Insertion torque values at the time of placement and time in function were also evaluated. Biometric statistics were computed with p-values (<0.05. Descriptive and bivariate statistics were computed; p-values were set at 0.05.
Five hundred forty-four patients (225 males; 319 females) average age 62.5 years (range 27 to 95) had 563 implants placed. Five hundred thirty-five of five hundred sixty-three (535/563) implants survived; 28 failed [clinical survival rate (CSR) 95.03%]. Number and time in function were: 0 to 12 years 100%; 0 to 9 years 85%; 0 to 6 years 69%; 0 to 3 years 35% or 10 to 12 years 16%; 7 to 9 years 16%; 4 to 6 years 34%; 0 to 3 years 35%. No significant differences were found between sex and implant failures (p = 0.22). Maxillary (266/285; 93.3%) and mandibular (269/278; 96.8%) implant CSRs were not significantly different. Three implant diameters were used: 7.0 mm (206/563) [36.6%]; 8.0 mm (267/563) [47.4%]; 9.0 mm (90/563) [15.9%]. Clinical survival rates were: 7.0 mm (201/206) [97.6%]; 8.0 mm (252/267) [94.4%]; 9.0 mm (82/90) [91.1%]. Mean age for patients with failed implants did not show any significant differences (p = 0.1398). Fifteen of the 28 failed implants failed within 120 days of surgical placement (prior to definitive restoration; [53.6%]; 4 implants failed between 4 and 12 months [14.3%]; 9 implants failed at least 1-year postloading [32.1%].
The results of this long-term retrospective study regarding ultrawide diameter implants suggested that these implants were viable treatment options for immediate molar replacement following tooth extraction in either jaw with an unloaded healing protocol. High clinical survival rates were reported over a 144-month (12-year) timeframe.
宏观种植体设计的创新，特别是直径7.0毫米或更大的超宽种植体，已使磨牙即刻种植成为可能。这是一项回顾性研究，评估即刻植入磨牙拔牙窝的超宽直径种植体（7.0、8.0、9.0毫米）的存活率。种植体植入后随访至144个月。
对2008年1月1日至2020年12月31日在一家私人外科诊所接受治疗的所有患者进行回顾性研究，这些患者接受了即刻植入磨牙拔牙窝的超宽牙科种植体（7.0、8.0、9.0毫米）。手术时在所有种植体上放置宽直径愈合基台。在至少4个月的无负载愈合后制作基台和牙冠修复体。检查患者的年龄、性别、种植体位置和种植体直径的存活率。还评估了植入时的植入扭矩值和使用时间。计算生物统计学数据，p值<0.05。计算描述性和双变量统计数据；p值设定为0.05。
544例患者（225例男性；319例女性），平均年龄62.5岁（范围27至95岁），共植入563颗种植体。563颗种植体中有535颗存活；28颗失败[临床存活率（CSR）95.03%]。使用数量和时间为：0至12年100%；0至9年85%；0至6年69%；0至3年35%或10至12年16%；7至9年16%；4至6年34%；0至3年35%。性别与种植体失败之间未发现显著差异（p = 0.22）。上颌（266/285；93.3%）和下颌（269/278；96.8%）种植体的CSR无显著差异。使用了三种种植体直径：7.0毫米（206/563）[36.6%]；8.0毫米（267/563）[47.4%]；9.0毫米（90/563）[15.9%]。临床存活率为：7.0毫米（201/206）[97.6%]；8.0毫米（252/267）[94.4%]；9.0毫米（82/90）[91.1%]。种植体失败患者的平均年龄未显示任何显著差异（p = 0.1398）。28颗失败种植体中有15颗在手术植入后120天内失败（在最终修复之前；[53.6%]）；4颗种植体在4至12个月之间失败[14.3%]；9颗种植体在加载后至少1年失败[32.1%]。
这项关于超宽直径种植体的长期回顾性研究结果表明，对于颌骨拔牙后即刻进行磨牙种植且采用无负载愈合方案的情况，这些种植体是可行的治疗选择。在144个月（12年）的时间范围内报告了较高的临床存活率。
