Monsalve-Guil L, Velasco-Ortega E, Ortiz-Garcia I, Matos-Garrido N, Moreno-Muñoz J, Núñez-Márquez E, Rondón-Romero J-L, López-López J, Jiménez-Guerra Á
C/Feixa Llarga s/n L´Hospitalet de Llobregat, 08927 Barcelona, Spain
Med Oral Patol Oral Cir Bucal. 2025 Jan 1;30(1):e76-e85. doi: 10.4317/medoral.26837.
Although there are many works analyzing the clinical behavior of immediate loading of implants inserted by guided surgery, the literature referring specifically to elderly patients is scarce. The aim of this investigation is to present the clinical outcomes of immediate loading of implants inserted by guided surgery in geriatric patients with edentulous maxilla.
The clinical data of 20 elderly patients with edentulous jaws are analyzed retrospectively. All were diagnosed with cone beam computed tomography, oral examination, and articulator-mounted models to analyze the intermaxillary relationship. They were treated with 4 to 10 implants by flapless guided surgery with immediate loading. After surgery, the implants were loaded with a temporary acrylic prosthesis and six months later, a definitive full-arch ceramic prosthesis was placed.
Twenty patients with an average age of 68.8 years (11 males and 9 females) underwent treatment with a total of 139 implants. Among them, 15 patients (75%) had a history of periodontitis. Ten patients (50%) smoked. Thirteen patients (65%) report a history oof systemic disease. The mean follow-up was 53.1 ± 21.4 months. The clinical outcomes indicated a 100% success rate for the implants. Twenty full-arch fixed maxillary rehabilitations were performed, with an average marginal bone loss of 1.37 mm (S.D. 0.53 mm.) Marginal bone loss was significantly greater for patients with a longer period of clinical follow-up. Peri-implantitis is reported in 17 implants (12.2%) in 8 patients (40%). Four patients (20%) showed some kind of mechanical prosthodontic complications.
The present work indicates that treatment with implant-supported fixed full-arch prostheses, in geriatric patients with edentulous jaws and through guided surgery and immediate loading, this implant protocol seems to be a successful.
尽管有许多研究分析了引导手术植入种植体即刻负重的临床行为，但专门针对老年患者的文献却很少。本研究的目的是介绍引导手术植入种植体即刻负重治疗老年上颌无牙颌患者的临床结果。
回顾性分析20例老年无牙颌患者的临床资料。所有患者均通过锥形束计算机断层扫描、口腔检查和架上模型分析来诊断，以分析颌间关系。他们接受了4至10枚种植体的无瓣引导手术并即刻负重。术后，种植体加载临时丙烯酸树脂修复体，6个月后，安装最终的全牙弓陶瓷修复体。
20例患者平均年龄68.8岁（男11例，女9例），共植入139枚种植体。其中，15例患者（75%）有牙周炎病史。10例患者（50%）吸烟。13例患者（65%）有全身疾病史。平均随访时间为53.1±21.4个月。临床结果显示种植体成功率为100%。共进行了20例全牙弓固定上颌修复，平均边缘骨吸收为1.37mm（标准差0.53mm）。临床随访时间较长的患者边缘骨吸收明显更大。8例患者（40%）的17枚种植体（12.2%）报告发生种植体周围炎。4例患者（20%）出现某种机械性修复并发症。
本研究表明，对于老年无牙颌患者，通过引导手术和即刻负重进行种植体支持的固定全牙弓修复治疗，该种植方案似乎是成功的。
