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即刻加载和早期加载具有亲水表面的即刻放置骨水平锥形牙科种植体在上颌全弓修复中的效果:一项具有 2 年随访的前瞻性随机临床试验。

Immediate versus early loading of immediately placed bone-level tapered dental implants with hydrophilic surface in full arch maxillary rehabilitation: A pilot randomized clinical trial with 2-year follow-up.

机构信息

Implant Center, School of Dental Medicine, University of Belgrade, Belgrade, Serbia.

Clinic of Prosthodontics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia.

出版信息

Clin Implant Dent Relat Res. 2024 Aug;26(4):688-703. doi: 10.1111/cid.13334. Epub 2024 May 1.

Abstract

This study aimed to compare implant stabilities between the immediate and early loaded, immediately placed bone-level tapered dental implants in the maxilla and to evaluate marginal bone loss (MBL), oral health-related quality of life (OHRQoL), and patient satisfaction at a 2-year follow-up. A pilot, prospective, randomized, controlled clinical trial was conducted on 24 maxillary failing dentition patients. The bone-level tapered implants of 12 patients were immediately loaded with temporary restorations, while the other 12 patients did not receive any kind of temporization. Implant-supported screw-retained complete porcelain-fused-to-metal prostheses were delivered to all patients in the seventh postoperative week. The insertion torque values of implants assigned to the immediate and early loading groups were 33.0 ± 4.87 and 29.26 ± 8.31 Ncm, respectively. The dynamics of implant stability changes from implant placement up to a 2-year follow-up were similar for both groups (Penguin®, p = 0.268; Ostell®, p = 0.552), while the MBL was at submillimeter level. The cumulative implant survival rate was 91.80% for immediately loaded implants and 97.22% for early loaded implants, without significant difference (p = 0.162). The total score on the Oral Health Impact Profile questionnaire significantly decreased over time in both groups, indicating improvement in OHRQoL (p < 0.001), and the high level of patient satisfaction remained after 2 years of function regardless of a loading protocol. Both loading protocols, immediate and early, of six immediately placed bone-level tapered dental implants are an adequate treatment choice for fixed rehabilitation of the maxillary failing dentition.

摘要

本研究旨在比较上颌即刻和早期负载、即刻植入骨水平锥形牙科种植体的稳定性,并在 2 年随访时评估边缘骨丧失(MBL)、口腔健康相关生活质量(OHRQoL)和患者满意度。一项前瞻性、随机、对照的临床试验纳入 24 例上颌失败牙列患者。其中 12 例患者的骨水平锥形种植体立即用临时修复体负载,而另 12 例患者则未进行任何形式的暂封。所有患者均在术后第 7 周植入种植体支持的螺钉固位全瓷熔附金属修复体。即刻负载组和早期负载组的种植体插入扭矩值分别为 33.0±4.87 和 29.26±8.31 Ncm。从种植体植入到 2 年随访期间,两组种植体稳定性变化的动态相似(Penguin®,p=0.268;Ostell®,p=0.552),而边缘骨丧失处于亚毫米水平。即刻负载种植体的累积种植体存活率为 91.80%,早期负载种植体的存活率为 97.22%,差异无统计学意义(p=0.162)。两组患者的口腔健康影响简表总评分均随时间逐渐降低,表明 OHRQoL 得到改善(p<0.001),且无论采用哪种负载方案,2 年功能后患者满意度仍保持高水平。即刻植入的 6 个骨水平锥形种植体即刻负载和早期负载两种加载方案均是上颌失败牙列固定修复的一种可行治疗选择。

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