颧骨种植体在严重上颌骨萎缩中的修复作用：一项 274 例颧骨种植体的回顾性研究，平均随访时间为 7.5 年。

Zygomatic implants in the rehabilitation of severe maxillary atrophy: A retrospective study of 274 zygomatic implants with a mean follow-up period of 7.5 years.

出版信息

Int J Oral Implantol (Berl). 2024 Nov 19;17(4):401-408.

Abstract

PURPOSE

Zygomatic implants are considered one of the last options for the rehabilitation of severe maxillary atrophy when standard implants cannot be placed. They offer several advantages but can also present complications. This study aimed to investigate the long-term clinical and radiographic outcomes of zygomatic implant placement.

MATERIALS AND METHODS

A retrospective chart review was conducted, and the inclusion criteria consisted of patients previously treated with zygomatic implants who had Class V or VI maxillary bone atrophy according to Cawood and Howell, and with a minimum follow-up period of 2 years after prosthetic loading. Outcome measures included implant and prosthesis survival rate, biological and biomechanical complications, and Lund-Mackay staging score before and after implant placement.

RESULTS

The study included 78 patients who received a total of 274 zygomatic implants. The mean follow-up period was 90.4 ± 26.0 months. Seventeen implant failures occurred, resulting in a survival rate of 93.8%, with a statistically significant negative correlation with smoking habits (P = 0.049), anchorage to the two zygomatic bone cortices (bicorticality) (P 0.001) and soft tissue complications (P 0.001). The prosthetic success rate was 92.3%. A statistically significant increase in maxillary sinus radiopacity was recorded when comparing the situation before and after surgery (P 0.001), and the intrasinus pathway had a statistically significant influence on that increase (P = 0.003).

CONCLUSIONS

Zygomatic implants utilised for rehabilitating patients with severe maxillary atrophy have shown favourable outcomes. Nonetheless, owing to potential complications, strict case selection is necessary, combined with regular recall visits and proper oral hygiene maintenance. Furthermore, this type of surgery necessitates specialised training and expertise on the part of the practitioner.

摘要

目的

当标准种植体无法植入时，颧骨种植体被认为是严重上颌萎缩患者的最后一种修复选择。它们具有多种优势，但也可能出现并发症。本研究旨在探讨颧骨种植体植入的长期临床和影像学结果。

材料与方法

进行了回顾性病历审查，纳入标准为先前接受过颧骨种植体治疗的患者，这些患者根据 Cawood 和 Howell 分类法存在 V 类或 VI 类上颌骨萎缩，且在修复体加载后至少有 2 年的随访期。研究结果包括种植体和修复体的存活率、生物和生物力学并发症以及植入前后 Lund-Mackay 分期评分。

结果

本研究共纳入 78 例患者，共植入 274 枚颧骨种植体。平均随访时间为 90.4 ± 26.0 个月。发生了 17 例种植体失败，存活率为 93.8%，与吸烟习惯呈显著负相关（P = 0.049），与颧骨骨皮质的双皮质固定（P 0.001）和软组织并发症（P 0.001）也呈显著负相关。修复体成功率为 92.3%。与术前相比，术后上颌窦射线可透性明显增加（P 0.001），且窦内途径对上颌窦射线可透性的增加有显著影响（P = 0.003）。