Kostunov Jana, Giannakopoulos Nikolaos Nikitas, Rammelsberg Peter, Kappel Stefanie
Department of Prosthodontics, University of Heidelberg, Heidelberg, Germany.
Department of Prosthodontics, University of Würzburg, Würzburg, Germany.
Clin Implant Dent Relat Res. 2025 Jun;27(3):e70033. doi: 10.1111/cid.70033.
In many clinical cases, anatomical conditions such as an atrophied alveolar ridge do not allow insertion of normal diameter implants. At this point, narrow dental implants may provide an effective option to avoid complex surgical treatments. The aim of this trial was to evaluate long-term survival, prosthetic and biological complications, and OHRQoL for two-piece narrow dental implants supporting overdentures with Locator-attachments.
Twenty-five patients with edentulous mandibles received four narrow dental implants and retained dentures with Locator attachments. Following successful implantation, immediate loading of anterior implants with Locator attachments was performed, while posterior implants underwent a conventional healing procedure. Follow-up examinations included documentation of implant and denture-related complications, modified gingiva index, modified plaque index, OHIP-G, and radiographic measurements of bone loss.
Up to 9 years after restoration, 18 patients with 72 implants were available for the follow-up. During the observation period, one implant was lost in the immediate loading group. Implant survival was 98% and 100%. The outcomes of mPI and mGI for the 18 patients hardly differed between the groups. During the observation period, 136 prosthetic complications occurred. Scores for the different OHIP-G domains at the last follow-ups were stable over the years.
Throughout an extended period of observation, we found stable implant survival rates, good maintenance of oral hygiene, and manageable prosthetic complications. The OHRQoL was satisfying over the years, suggesting that this treatment option could be favorable for older individuals.
在许多临床病例中，诸如牙槽嵴萎缩等解剖条件不允许植入正常直径的种植体。此时，窄径牙种植体可能为避免复杂的外科治疗提供一种有效的选择。本试验的目的是评估用于支持带有Locator附着体覆盖义齿的两件式窄径牙种植体的长期生存率、修复和生物学并发症以及口腔健康相关生活质量（OHRQoL）。
25例下颌无牙患者接受了4颗窄径牙种植体，并佩戴带有Locator附着体的保留义齿。成功植入后，对前部种植体立即进行带有Locator附着体的加载，而后部种植体则采用传统的愈合程序。随访检查包括记录种植体和义齿相关并发症、改良牙龈指数、改良菌斑指数、OHIP-G以及骨吸收的影像学测量。
修复后长达9年，18例患者的72颗种植体可供随访。在观察期内，即刻加载组有1颗种植体丢失。种植体生存率分别为98%和100%。18例患者的改良菌斑指数（mPI）和改良牙龈指数（mGI）结果在两组之间几乎没有差异。在观察期内，发生了136例修复并发症。在最后几次随访中，不同OHIP-G领域的评分多年来保持稳定。
在较长的观察期内，我们发现种植体生存率稳定、口腔卫生维持良好且修复并发症可控。多年来OHRQoL令人满意，表明这种治疗选择可能对老年个体有利。
