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一项随机、多中心、双盲平行研究,旨在评估唑来膦酸涂层与未涂层牙种植体在部分牙列缺损患者中的安全性和性能。

A randomized, multicenter, double-blinded parallel study to evaluate the safety and performance of zoledronate-coated versus uncoated dental implants in partially edentulous patients.

作者信息

Mokhtari Reza A, Olsson Morgan, Östman Per-Olov, Dahlin Christer

机构信息

Department of ENT & Oral and Maxillofacial Surgery, Nu-Sjukvården, Trollhättan, Sweden.

Department of Biomaterials, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

出版信息

Clin Implant Dent Relat Res. 2024 Feb;26(1):78-87. doi: 10.1111/cid.13288. Epub 2023 Oct 17.

Abstract

OBJECTIVE

To evaluate patient safety, implants survival and implant stability of the bisphosphonate (zoledronate) as a coating on dental implants in patients requiring oral rehabilitation in the posterior maxilla.

MATERIALS AND METHODS

In this multicenter, double-blind, randomized controlled study, 62 patients were randomized to receive either zoledronate-coated or uncoated control implants in the premolar or molar area of the maxilla, using a one stage-protocol. Due to dropouts and exclusion 49 patients completed the study. The implants were examined by resonance frequency analysis (RFA) using an implant stability quotient (ISQ) scale at the time of insertion, and at 8 weeks, and after 12 weeks prior to prosthetic restoration. Radiographs were taken prior to surgery, directly after insertion, and during the follow-up at 12 weeks, 6 months, and 1 year to analyze changes in marginal bone levels (MBL). Finally, all complications and adverse effects (AE) were observed and recorded.

RESULTS

Out of 62 included patients, 49 patients completed the study. No AE were reported by patients receiving zoledronate-coated implants. There was no statistically significant difference between the zoledronate-coated or uncoated implant groups when comparing ISQ levels at insertion and after 12 weeks of healing, the mean of the ISQ values demonstrated a change of 4.64 (95% confidence interval: 15.46; 5.79, p = 0.43) between the two groups. At 8- and 12-weeks, ISQ values remained stable (range 62-70). Radiographic analysis showed no statistically significant difference in MBL between the two implant groups after 1 year of loading neither at the mesial side (p = 0.99) or the distal side (p = 0.97). MBL for coated implants were 0.57 mm at the mesial side and 0.46 mm at the distal side. For the uncoated implants, MBL was 0.48 mm at the mesial side and 0.47 mm at the distal side.

CONCLUSION

The zoledronate-coated dental implants are safe to use in a one-stage surgery protocol in patients requiring oral rehabilitation in the posterior maxilla, after 1 year of loading. There were no statically significant changes in implant stability and marginal bone levels measured by intraoral radiographs in comparison to uncoated control implants.

摘要

目的

评估唑来膦酸盐作为涂层应用于上颌后牙区需要口腔修复患者的牙种植体时的患者安全性、种植体存留率及种植体稳定性。

材料与方法

在这项多中心、双盲、随机对照研究中,62例患者采用一期手术方案,被随机分配至在上颌前磨牙或磨牙区接受唑来膦酸盐涂层种植体或未涂层对照种植体。由于失访和排除,49例患者完成了研究。在种植体植入时、8周时以及修复前12周,使用种植体稳定性商数(ISQ)量表通过共振频率分析(RFA)对种植体进行检查。在手术前、植入后即刻以及随访的12周、6个月和1年时拍摄X线片,以分析边缘骨水平(MBL)的变化。最后,观察并记录所有并发症和不良反应(AE)。

结果

62例纳入患者中,49例患者完成了研究。接受唑来膦酸盐涂层种植体的患者未报告AE。在比较植入时和愈合12周后的ISQ水平时,唑来膦酸盐涂层种植体组与未涂层种植体组之间无统计学显著差异,两组间ISQ值的平均值变化为4.64(95%置信区间:15.46;5.79,p = 0.43)。在8周和12周时,ISQ值保持稳定(范围62 - 70)。影像学分析显示,在加载1年后,两组种植体在近中侧(p = 0.99)或远中侧(p = 0.97)的MBL无统计学显著差异。涂层种植体近中侧的MBL为0.57 mm,远中侧为0.46 mm。未涂层种植体近中侧的MBL为0.48 mm,远中侧为0.47 mm。

结论

对于上颌后牙区需要口腔修复的患者,在一期手术方案中使用唑来膦酸盐涂层牙种植体,在加载1年后是安全的。与未涂层对照种植体相比,通过口腔内X线片测量的种植体稳定性和边缘骨水平无统计学显著变化。

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