FRIALIT-2球帽固位种植覆盖义齿修复低平下颌牙槽嵴的疗效观察

目的：评价FRIALIT-2球帽固位的种植覆盖义齿修复下颌牙列缺失且牙槽嵴低平的临床效果。方法：将6例下颌牙列缺失且牙槽嵴低平的患者植入2颗FRIALIT-2种植法，利用FRIALIT-2球帽附着体固位制作覆盖义齿，进行12-24个月的临床追踪。结果：覆盖义齿的固位及使用效果均满意，种植体周围骨高度第一年平均降低0.8mm，有4颗种植体周围粘膜红肿，有3例患者需要重衬，有2例患者覆盖义齿折断，结论：球帽固位种植覆盖义齿是下颌牙列缺失且牙槽嵴低平者有效修复方式。     

Immediate loading of mandibular overdentures supported by unsplinted direct laser metal-forming implants: results from a 1-year prospective study

Background: At present, only some studies have dealt with immediate loading of unsplinted implants supporting mandibular overdentures. The aim of this prospective study is to evaluate treatment outcomes of mandibular overdentures supported by four one‐piece, unsplinted, immediately loaded, direct laser metal‐forming (DLMF) implants by assessing implant survival rate, implant success, marginal bone loss, and prosthetic complications. Methods: A total of 96 one‐piece DLMF implants were inserted in the edentulous mandible of 24 patients. Four implants were placed in each edentulous mandible. Immediately after implant placement, a mandibular overdenture was connected to the implants. At 1‐year follow‐up, clinical, radiographic, and prosthetic parameters were assessed. Success criteria included absence of pain, suppuration, and implant mobility; absence of continuous peri‐implant radiolucency; and distance between the implant shoulder and the first visible bone contact <1.5 mm. Results: After a 1‐year loading time, the overall implant survival rate was 98.9%, with only one implant lost. Among the surviving 95 implants, two did not fulfill the success criteria; therefore, the implant success rate was 97.8%. The mean distance between the implant shoulder and the first visible bone contact was 0.28 ± 0.30 mm (95% confidence interval, 0.24 to 0.32). Some prosthetic complications were reported. Conclusion: Based on the present results and within the limits of this study, the immediate loading of four unsplinted DLMF implants by means of ball attachment–supported mandibular overdentures seems to represent a safe and successful procedure.     

种植体支持套筒冠固位全口覆盖义齿即刻负重3例

对3例全口无牙颌或重度慢性牙周炎牙列缺损患者术前制作全口义齿或即刻全口义齿,拔除全口余留牙,在下颌植入4颗Ankylos种植体,上颌植入6颗种植体,将SynCone套筒基台接入种植体,再套入预成圆锥形外冠,完成临时义齿修复。3～12个月后将临时义齿更换为铸造支架覆盖义齿。随访12～24个月,除1例种植体在植入后1个月松动拔除而重新植入种植体外,其余种植体均未出现明显的牙槽骨吸收。     

下颌即刻负荷种植覆盖义齿3～5年临床观察

目的 探讨种植体支持的覆盖义齿即刻负荷后种植体的长期稳定性.方法 对北京大学口腔医学院·口腔医院第一门诊部就诊的10例牙列缺失患者采用Ankylos SynCone种植系统支持的即刻负荷覆盖义齿修复,均为下颌全颌覆盖义齿.10例均在下颌颏孔之间植入4枚种植体,共植入40枚,修复后平均随访3～5年,以共振频率分析和影像学检查评价种植体稳定性和边缘骨丢失情况.结果 所有种植体无松动脱落,均获得良好的骨结合,存留率为100％;种植体稳定性指数值均＞ 65,与临床检查种植体稳定性良好一致.种植体周软组织健康,未见X线连续透射影,边缘骨吸收＜1 mm.结论 下颌即刻负荷种植覆盖义齿修复3～5年随访临床效果满意.     

Marginal bone loss adjacent to conventional and immediate loaded two implants supporting a ball-retained mandibular overdenture: a 3-year randomized clinical trial

Objectives: The aim of this study was to evaluate and compare marginal bone loss and clinical outcomes of conventionally and immediately loaded two implants supporting a ball‐retained mandibular overdenture. Materials and methods: Thirty six completely edentulous patients (22 males and 14 females) were randomly assigned into two groups. Each patient received two implants in the canine area of the mandible after a minimal flap reflection. Implants were loaded by mandibular overdentures either 3 months (conventional loading group) or the same day (immediate loading group) after implant placement. Ball attachments were used to retain all overdentures to the implants. Vertical and horizontal alveolar bone losses were evaluated in both groups 1 and 3 years after implant placement using multislice computed tomography, which allow evaluation of peri‐implant buccal and lingual alveolar bone. Plaque scores, gingival scores, probing depths and periotest values (PTVs) were evaluated at 4 months (baseline), 1 and 3 years after implant placement. Clinical and radiographic evaluations were performed at distal, labial, mesial and lingual peri‐implant sites. Results: After 3 years of follow‐up period, the immediate loading group recorded significant vertical bone loss at distal and labial sites than the conventional loading group and no significant differences in horizontal bone loss between groups were observed. Probing depth at distal and labial sites in the immediate loading group were higher than the conventional loading group, while plaque scores, gingival scores and PTVs showed no significant differences between the two groups. A low level of positive correlation between plaque scores, gingival scores, probing depths and vertical bone loss was noted. Conclusion: Immediately loaded two implants supporting a ball‐retained mandibular overdenture are associated with more marginal bone resorption and increased probing depths when compared with conventionally loaded implants after 3 years. The bone resorption and probing depths at distal and labial sites are significantly higher than those at mesial and lingual sites. Clinical outcomes do not differ significantly between loading protocols. To cite this article :
Elsyad MA, Al‐Mahdy YF, Fouad MM. Marginal bone loss adjacent to conventional and immediate loaded two implants supporting a ball‐retained mandibular overdenture: a 3‐year randomized clinical trial.
Clin. Oral Impl. Res. 23 , 23, 2012 496‐503.
doi: 10.1111/j.1600‐0501.2011.02173.x     

The clinical and radiographic outcome of immediately loaded mini implants supporting a mandibular overdenture. A 3-year prospective study

This article aimed to examine the clinical and radiographic outcome of mini dental implants (MDIs) supporting a mandibular overdenture. Twenty-eight patients (16 men and 12 women) complaining from insufficient retention of their mandibular denture received a total of 112 MDIs (four per patient) in the interforaminal area of the mandible using the non-submerged flapless surgical approach. Implants were immediately loaded with mandibular overdentures after implant insertion. Each implant was evaluated at the time of initial prosthetic loading, 6, 12, 24 and 36 months thereafter. Clinical evaluation was performed using plaque index (PI), gingival index (GI), probing depth (PD) and periotest values (PTVs). Radiographic evaluation was performed in terms of vertical (VBLO) and horizontal (HBLO) alveolar bone loss. Cumulative success and survival rates were calculated using life table analysis. Plaque index, GI, PD, VBLO and HBLO increased significantly in the first year after overdenture insertion, and no significant difference between subsequent observations was noted. Periotest values demonstrated no significant difference between observation times. The cumulative survival and success rates of MDIs were 96·4% and 92·9%, respectively. Within the limitations of this study, clinical and radiographic peri-implant tissue responses of immediately loaded MDIs supporting a mandibular overdenture were favourable after 3 years. However, randomised, controlled clinical trials are needed to compare these responses to that of conventional-diameter implants.     

Immediate functional loading of implants in single tooth replacement: a prospective clinical multicenter study

Objectives: The aim of the present study was to evaluate the outcome of immediate functional loading of implants in single-tooth replacement using two different installation procedures.
Material and Methods: One hundred and fifty-one subjects, who required single-tooth rehabilitation in the area of 15–25 and 35–45, were enrolled in eight private clinics in Italy. The implant sites were randomly allocated to one of the following treatment groups. In the control group, in which a standard preparation procedure for implant placement and submerged healing of the implant was used, abutment connection and loading of the implants were performed 3 months after installation. In the test group 1, a standard preparation procedure for the implant placement and immediate functional loading of implant was carried out. In the test 2 group, however, a modified implant installation procedure (osteotome technique) was used followed by immediate functional loading of the implant. Clinical and radiographic examinations were performed at 3 and 12 months of follow-up at all sites.
Results: Three implants (5.5%) from the test 2 group (osteotome preparation) and one (2%) from the test 1 group (conventional drill preparation) failed to integrate and were removed one and three months after implant installation. The mean marginal bone loss assessed at 12 months was 0.31 mm (test 1), 0.25 mm (test 2) and 0.38 mm (control) (no statistically significant differences were found between the three treatment groups.)
Conclusion: It is suggested that immediate functional loading of implants that are placed with a conventional installation technique and with sufficient primary stability may be considered as a valid treatment alternative in a single-tooth replacement.     

Early versus late loading of unsplinted TiUnite surface implants supporting mandibular overdentures: a 2-year report from a prospective study

The aim of this study was to evaluate the clinical performance of the implants supporting mandibular overdentures, and to investigate the prosthodontic outcomes of the mandibular implant overdentures. Twenty edentulous patients participated in this study. Forty implants were placed in the canine areas of the mandibles of all patients using the 1-stage approach. New maxillary complete dentures and the mandibular implant overdentures were delivered to 10 patients in the test group 1 week after surgery, while new maxillary and mandibular complete prostheses were delivered to 10 patients in the control group. These conventional mandibular prostheses were converted to mandibular implant overdentures 3 months after surgery. No implants were lost neither in test nor in control group. The average ISQ values between the two groups were not statistically significant during 2 years (P > 0.05). The average marginal bone resorptions were 0.4 and 0.5 mm for the test and the control group after 2 years. The number of appointments required for the prosthodontic maintenance of the mandibular implant overdentures in the first year was higher than that in the second year, which was statistically significant(P < 0.001). The results of the study suggest that the 1-week early loading approach does not adversely influence the clinical performance of the implants supporting mandibular overdentures.     

全口即刻负重种植固定义齿2例

对2例全口多数牙缺失、残留少量重度牙周炎患牙的患者拔除全口余牙,即刻于上下颌分别植入10颗和8颗Straumann种植体,36颗种植体经共振频率分析,种植体稳定指数（ISQ）值大于60的34颗种植体即刻接入临时基台行复合树脂临时固定桥修复,3个月左右种植体形成骨整合后完成永久性修复。修复后追踪18～26个月,无1颗种植体失败,平均累积骨丧失为0.41 mm。     

Immediate loading of implants in the edentulous maxilla: use of an interim fixed prosthesis followed by a permanent fixed prosthesis: a 32-month prospective radiological and clinical study

Purpose: The aim of this study was to prospectively evaluate the survival rate of splinted and immediately loaded Straumann sandblasted, large-grit, acid-etched, solid-screw dental implants in the edentulous maxilla after 32 months of loading.
Materials and Methods: Twenty-eight patients (mean age 63 years) with edentulous maxillae received 168 implants (six each) and an implant-supported fixed interim prosthesis within 24 hours after surgery. After a mean healing time of 15 weeks, the patients received permanent screw-retained prostheses. Clinical and radiological examinations were made at implant placement and after 8, 20, and 32 months of loading. All permanent prostheses were removed at the 32-month follow-up; implant stability was checked with a torque device, and the implant stability quotient was determined with resonance frequency analysis.
Results: Mean marginal bone loss from baseline to 8 months after loading was 1.6 mm (SD 1.16; p  = .094), from 8 to 20 months 0.41 mm (SD 0.63; p  = .094), and from 20 to 32 months 0.08 mm (SD 0.49; p  = .039). The 32-month cumulative survival rate was 98.2%.
Conclusions: The 32-month survival of solid-screw implants – immediately loaded within 24 hours after placement – was similar to survival rates reported for solid-screw implants with conventional loading. Immediate loading and splinting of implants in the edentulous maxilla is a viable treatment alternative.     

One-year clinical and radiographic assessment of fluoride-enhanced implants on immediate non-functional loading in posterior maxilla and mandible: a pilot prospective clinical series study

Objective: The functional, esthetic, and psychological problems of 3–6 months of edentulousness and also discomfort of two‐stage surgery might cause many patients to avoid implant‐supported restorations. Therefore, the immediate non‐functional loading protocol might be of value. Methods: Twenty Astra Tech implants, 11–13 mm in length and 3.5–4 mm in diameter, were placed in maxillary and mandibular posterior sites of 10 healthy patients (two for each) with adequate alveolar bone. Temporary prostheses were relieved of all centric and eccentric contacts. Functional permanent prostheses were fabricated 13 weeks postoperatively. Clinical and radiographic examinations (including the implant stability quotient [ISQ]) were carried out immediately after implantation and 3, 6, and 12 months postoperatively. Results: A 100% success rate was observed within 1 year. The plaque and bleeding indices, and pocket‐probing depths did not show a significant change throughout the study. The ISQ values after implant insertion, and 3, 6, and 12 months later were respectively 76.6 ± 6.57, 77.6 ± 10.54, 81.8 ± 6.8, and 82.43 ± 3.7. The increase was statistically significant (P=0.004) according to the Freidman test. The ISQ values measured after the implant insertion were significantly different from those measured in the sixth and 12th postoperative months (P<0.008) according to the Wilcoxon signed‐ranks test. The mean crestal alveolar bone resorption values in the third, sixth, and 12th postoperative months were 0.4 ± 0.55, 0.48 ± 0.37, and 0.48 ± 0.21 mm, respectively; and the change in marginal alveolar bone loss was not significant according to the Freidman test. Conclusion: Within the limitations of this pilot study, non‐functional immediate loading might meet the expectations of both the patients and clinicians. To cite this article:
Rismanchian M, Fazel A, Rakhshan V, Eblaghian G. One‐year clinical and radiographic assessment of fluoride‐enhanced implants on immediate non‐functional loading in posterior maxilla and mandible: a pilot prospective clinical series study.
Clin. Oral Impl. Res. xx , 2011; 000–000.
doi: 10.1111/j.1600‐0501.2010.02134.x     

即刻负载的下颌套筒冠种植义齿在重度牙周病患者中的应用研究

目的介绍即刻负载的下颌套筒冠种植义齿在重度牙周炎患者中的应用,并评价其临床疗效。方法选择22位重度牙周炎患者,下颌颏孔区之间共植入88枚Ankylos种植体,采用Syncone套筒冠基台进行即刻修复、即刻负载,3个月后用纯钛支架义齿进行永久修复。修复完成后随访12~27个月,观察种植体周围软硬组织状况,计算存留率和成功率,调查患者满意度。结果 12~27个月观察期内,88枚种植体无脱落,存留率100%;仅有2枚边缘骨吸收大于2 mm,成功率达到97.73%;软组织状况均明显好转,牙周袋深度减小,探诊出血百分比降低,具有统计学差异;90.9%的患者都认为套筒冠义齿固位力足够,81.8%的患者认为使用12~27个月后,固位力无明显下降,95.46%的患者对这种义齿感到"比较满意"或者"非常满意"。结论即刻负载的下颌套筒冠种植义齿具有很高的存活率、成功率和患者满意度,有利于促进牙周病患者的软硬组织健康。     

临时种植体即刻负载在半颌即刻种植中的应用

目的：评价临时种植体即刻负载在半颌即刻种植中的应用效果。方法：20例半颌即刻种植患者行136枚即刻种植体植入,采用95枚临时种植体即刻负载恢复患者牙列。3-6月后行固定修复。结果：即刻负载临时种植体和即刻种植体成功率达100%。结论：临时种植体即刻负载半颌即刻种植是很好的临床方法。     

Immediate loading of dental implants

The purpose of this review is to explore the concept of immediate loading as it pertains to dental implants and the indications for clinical practice. The definition of immediate loading will be considered together with a review of the relevant literature in an attempt to provide evidence-based guidelines for successful implementation into practice.
A search of electronic databases including Medline, PubMed and the Cochrane Database of Systematic Reviews was undertaken using the terms ``immediate loading', ``dental implants', ``immediate function', ``early loading', ``oral implants', ``immediate restoration' and ``systematic review'. This was supplemented by handsearching in peer-reviewed journals and cross-referenced with the articles accessed. Emphasis was given to systematic reviews and controlled clinical trials.
A definition of immediate loading was suggested pertinent to the realities of logistics in clinical practice with respect to application and time frame. The literature was evaluated and shown to be limited with significant shortcomings. Guidelines and recommendations for clinical protocols were suggested and illustrated by examples of case types with a minimum of 1–3 years follow-up. A list of additional references for further reading was provided.
Within the limitations of this review, there is evidence to suggest that immediate loading protocols have demonstrated high implant survival rates and may be cautiously recommended for certain clinical situations. However, more high level evidence studies, preferably randomized controlled trials (RCTs), over a long time frame are required to show a clear benefit over more conventional loading protocols.