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颧骨种植体与骨膜下种植体的五年对比研究：严重上颌骨萎缩的临床结果、并发症及治疗策略

Five-Year Comparative Study of Zygomatic and Subperiosteal Implants: Clinical Outcomes, Complications, and Treatment Strategies for Severe Maxillary Atrophy.

作者信息

Zielinski Rafal, Okulski Jakub, Piechaczek Martyna, Łoś Jan, Sowiński Jerzy, Sadowska-Sowińska Monika, Kołkowska Agata, Simka Wojciech, Kozakiewicz Marcin

机构信息

StomatologianaKsiezymMlynie, 16D Tymienieckiego, 90-365 Lodz, Poland.

Department of Maxillofacial Surgery, Medical University of Lodz, 113st Zeromskiego, 90-001 Lodz, Poland.

出版信息

J Clin Med. 2025 Jan 21;14(3):661. doi: 10.3390/jcm14030661.

DOI:10.3390/jcm14030661
PMID:39941332
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11818549/
Abstract

: Severe maxillary atrophy presents challenges in maxillofacial rehabilitation. This study compares the clinical outcomes of zygomatic and subperiosteal implants, focusing on implant survival, soft tissue management, and postoperative complications over a five-year follow-up. : A retrospective cohort study analyzed 150 patients divided into two groups based on the type of implant. Zygomatic implants were assessed for immediate functional loading, procedural efficiency, and complications such as sinus-related issues and orbital damage. Subperiosteal implants were evaluated for their customized design, keratinized mucosa integration, and adaptation to severe anatomical limitations. Statistical analyses, including Chi-square tests, were used to determine significant differences ( < 0.05). : This study demonstrated differences in complication rates (sinus-related complications: 12.4% for zygomatic implants; peri-implantitis: 5.6% for subperiosteal implants). Implant survival rates were comparable (zygomatic: 96.3%, subperiosteal: 97.1%, = 0.278). Zygomatic implants demonstrated higher incidences of sinus-related complications (12.4%) and risks of orbital damage. Subperiosteal implants exhibited superior soft tissue stability with fewer cases of peri-implantitis (5.6%, < 0.05). Procedural duration was shorter for zygomatic implants (177 min vs. 123 min); however, subperiosteal implants allowed for re-implantation after failure, providing flexibility that was unavailable with zygomatic implants. : Zygomatic implants excel in immediate functional loading and reduced procedural time but require advanced surgical expertise to mitigate anatomical risks. Subperiosteal implants offer a safer, customizable solution, particularly in anatomically complex cases. These findings emphasize the importance of individualized treatment planning and technological advancements in implant design to optimize clinical outcomes for patients with severe maxillary atrophy.

摘要

严重的上颌骨萎缩给颌面修复带来了挑战。本研究比较了颧骨种植体和骨膜下种植体的临床效果，重点关注五年随访期内的种植体存活率、软组织管理和术后并发症。：一项回顾性队列研究分析了150例患者，根据种植体类型分为两组。对颧骨种植体进行了即刻功能负重、手术效率以及鼻窦相关问题和眼眶损伤等并发症的评估。对骨膜下种植体的定制设计、角化黏膜整合以及对严重解剖学限制的适应性进行了评估。采用包括卡方检验在内的统计分析来确定显著差异（<0.05）。：本研究显示了并发症发生率的差异（鼻窦相关并发症：颧骨种植体为12.4%；种植体周围炎：骨膜下种植体为5.6%）。种植体存活率相当（颧骨种植体：96.3%，骨膜下种植体：97.1%，P = 0.278）。颧骨种植体的鼻窦相关并发症发生率较高（12.4%），眼眶损伤风险也较高。骨膜下种植体表现出更好的软组织稳定性，种植体周围炎病例较少（5.6%，P<0.05）。颧骨种植体的手术时间较短（177分钟对123分钟）；然而，骨膜下种植体在失败后允许再次植入，提供了颧骨种植体所不具备的灵活性。：颧骨种植体在即刻功能负重和缩短手术时间方面表现出色，但需要先进的手术专业知识来降低解剖学风险。骨膜下种植体提供了一种更安全、可定制的解决方案，特别是在解剖结构复杂的病例中。这些发现强调了个体化治疗计划和种植体设计技术进步对于优化严重上颌骨萎缩患者临床效果的重要性。

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