Waltenberger Lukas, Reich Sven, Zwahlen Marcel, Wolfart Stefan
Department of Prosthodontics and Biomaterials, Centre for Implantology, RWTH Aachen University Hospital, Aachen, Germany.
Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Clin Implant Dent Relat Res. 2024 Dec;26(6):1135-1148. doi: 10.1111/cid.13374. Epub 2024 Aug 19.
The SafetyCrown workflow facilitates the immediate restoration of posterior single sites with the one-abutment/one-time concept. This randomized clinical trial aimed to assess the direct effect of immediate restoration on dental patient-reported outcomes (dPROs), feasibility, implant accuracy, and time.
Participants with a single posterior edentulous site for late implant placement underwent optical impressions, shade selection, and cone beam computed tomography. After virtual treatment planning, they were randomized into the test group and the control group. For the test group, individual definitive hybrid abutments were prefabricated. The next step was a fully guided surgery with printed guides. After the implant was placed using guided surgery, the abutment was inserted. A chairside CAD/CAM workflow was used to provide the patient with a provisional restoration. Implants in the control group were left submerged to heal. Oral health-related quality of life (OHRQoL) was assessed using the OHIP-G14, and dPRO was measured using a 10-item visual analog scale (VAS) questionnaire. Additional measurements of implant accuracy and time were performed. Follow-up was performed 7 to 10 days after implant placement.
Thirty-nine participants with 45 restorations were included (test group: 23, control: 22). Immediate restoration was successful in 21 out of 23 implants (91.3%) in the test group. Both groups exhibited decreased OHRQoL without significant intergroup differences, while patient satisfaction was high overall. Test group participants perceived higher benefits and satisfaction with immediate loading than participants in the control group. Implant accuracy averaged 0.60 mm at the shoulder and 0.95 mm at the apex. Operative time was longer in the immediate loading group (61.9 min) than in the control group (32.1 min) (p < 0.001).
Considering the limitations, the immediate restoration of late placed posterior implants using the described workflow proved feasible in 21 out of 23 cases. Both groups achieved high patient satisfaction with no differences in OHRQoL during the first week. Patients who received immediate loading rated the benefits very highly and were satisfied with the provisional restoration during the healing period.
SafetyCrown工作流程有助于采用单基台/一次性概念对后牙单颗种植位点进行即刻修复。这项随机临床试验旨在评估即刻修复对牙科患者报告结局(dPROs)、可行性、种植体准确性和时间的直接影响。
对晚期种植的单颗后牙无牙颌位点参与者进行光学印模、比色和锥形束计算机断层扫描。经过虚拟治疗计划后,将他们随机分为试验组和对照组。对于试验组,预先制作个性化定制的混合基台。下一步是使用打印导板进行完全引导手术。在使用引导手术植入种植体后,插入基台。采用椅旁CAD/CAM工作流程为患者提供临时修复体。对照组的种植体保持埋入状态以愈合。使用OHIP-G14评估口腔健康相关生活质量(OHRQoL),并使用10项视觉模拟量表(VAS)问卷测量dPRO。还进行了种植体准确性和时间的额外测量。在种植体植入后7至10天进行随访。
纳入了39名有45颗修复体的参与者(试验组:23名,对照组:22名)。试验组23颗种植体中有21颗即刻修复成功(91.3%)。两组的OHRQoL均有所下降,但组间无显著差异,而总体患者满意度较高。试验组参与者比对照组参与者对即刻负重的益处和满意度更高。种植体肩部平均准确性为0.60毫米,根尖平均准确性为0.95毫米。即刻负重组的手术时间(61.9分钟)比对照组(32.1分钟)长(p < 0.001)。
考虑到局限性,使用所描述的工作流程对晚期植入的后牙种植体进行即刻修复在23例中有21例被证明是可行的。两组在第一周的患者满意度都很高,OHRQoL无差异。接受即刻负重的患者对益处评价很高,并对愈合期的临时修复体感到满意。