Menchini-Fabris Giovanni-Battista, Toti Paolo, Tommaso Grandi, Paoleschi Cesare, Paoleschi Luisa, Covani Ugo
Int J Periodontics Restorative Dent. 2025 Jan 14;0(0):1-29. doi: 10.11607/prd.7114.
The study aimed to compare the short-term outcomes (3.7±0.4yrs) of full-arch immediately loaded fixed maxillary prostheses supported by conventional and unilateral single zygomatic implants versus those supported by conventional and bilateral single zygomatic implants.
A retrospective analysis was conducted on patients suffering severe bone loss in the posterior area of the maxilla. The success of zygomatic implants was defined following Offset-Rhinosinusitis-Infection-Stability (ORIS) criteria. The criteria used to define success of standard dental implants were absence of mobility, pain, discomfort/neurologic disorder, and of persistent or chronic infection. The level of significance was 0.01.
Thirty-eight patients received 2-5 standard implants plus two zygomatic implants (bilateral), whereas 10 patients had 3-5 standard implants plus a single zygomatic implant (unilateral). The cumulative success rate for standard implants was 99% and 97.3%, respectively, in the bilateral and unilateral groups. Four patients showed symptoms of acute rhinosinusitis (R-criterion): 1 in the unilateral and 3 in the bilateral group. Following the O-criterion, just 2 dental implants in the bilateral group showed a success grade 1. One zygomatic implant, belonging to the group bilateral, developed peri-implant mucositis with a success grade 3 (I-criterion). All zygomatic implants were checked individually and did not show either any signs of mobility or rotation after applying forces to the implant (S-criterion). The ORIS criteria divided the implants into three groups according to the success grades I,II,III: 32,36,8 for the bilateral, and 6,1,3 for the unilateral group, with no significant difference between the two groups. No zygomatic implant failure occurred so that the same zygomatic implant success rate (100%) was recorded for both groups. A prosthetic failure was registered in the unilateral group. The overall prosthesis success rates were 89.5% and 70%, respectively, in the bilateral and unilateral groups.
A high degree of success was achieved for both groups treated with zygomatic implants, although in group unilateral there was one failure of a standard dental implant placed in the posterior area. This suggested that the use of zygomatic implants could provide adequate support to the fixed full-arch prostheses even in the configuration with a single unilateral zygomatic implant.
本研究旨在比较由传统种植体和单侧单颗颧骨种植体支持的全牙弓即刻负重固定上颌修复体与由传统种植体和双侧单颗颧骨种植体支持的全牙弓即刻负重固定上颌修复体的短期效果（3.7±0.4年）。
对患有上颌后部严重骨量流失的患者进行回顾性分析。颧骨种植体的成功按照鼻窦偏移-鼻窦炎-感染-稳定性（ORIS）标准来定义。用于定义标准牙种植体成功的标准为无松动、疼痛、不适/神经功能障碍以及无持续性或慢性感染。显著性水平为0.01。
38例患者接受了2 - 5颗标准种植体加两颗颧骨种植体（双侧），而10例患者接受了3 - 5颗标准种植体加一颗颧骨种植体（单侧）。双侧组和单侧组中标准种植体的累积成功率分别为99%和97.3%。4例患者出现急性鼻窦炎症状（R标准）：单侧组1例，双侧组3例。按照O标准，双侧组仅有2颗牙种植体显示成功等级为1。双侧组中有一颗颧骨种植体发生种植体周围黏膜炎，成功等级为3（I标准）。所有颧骨种植体均单独检查，在对种植体施加力后未显示任何松动或旋转迹象（S标准）。ORIS标准根据成功等级I、II、III将种植体分为三组：双侧组分别为32颗、36颗、8颗，单侧组分别为6颗、1颗、3颗，两组之间无显著差异。未发生颧骨种植体失败，两组的颧骨种植体成功率均为100%。单侧组记录到一例修复体失败。双侧组和单侧组的总体修复体成功率分别为89.5%和70%。
两组使用颧骨种植体均取得了较高的成功率，尽管单侧组中后部区域植入的一颗标准牙种植体出现了失败。这表明即使在单侧单颗颧骨种植体的配置下，使用颧骨种植体也可为固定全牙弓修复体提供足够的支持。
