不同冠根比对种植单冠修复体临床效果的影响

目的 探讨种植牙冠根比对种植体生存率、种植体周围骨组织吸收的影响.方法 选择2008年1月至2009年2月间52例种植修复的患者,均部分或个别牙缺失,采用延期种植技术,共植入83颗ITI种植体.在种植体完成冠修复时和功能负载3年后分别对种植牙采用标准化X线投照技术,拍摄种植体数字化牙片.利用CliniView 6.1.3软件,分别测量计算出种植牙的冠根比与种植体周围骨垂直高度丧失的数值.结果 观察期间3例患者4颗种植体失败,种植体的3年累积生存率为95.2％;解剖冠根比平均为(0.99±0.32);临床冠根平均为(1.41±0.33).不同种植体冠根比之间的生存率没有明显差异(P＞0.05).种植体周围骨垂直高度丧失平均值为(-0.64±0.30) mm.按解剖冠根比小于1、1～ 1.9和大于或等于2将种植体分为3组,骨垂直高度丧失分别为(-0.86±0.25) mm、(-0.46±0.20)mm和-0.11 mm,各组间的差异无统计学意义(P＞ 0.05).按临床冠根比小于1、1 ～ 1.4、1.5 ～ 1.9和大于或等于2将种植体分为4组,骨垂直高度丧失量分别为(-1.84±0.84) mm、(-0.77 ± 0.08)mm、(-0.36±0.09)mm和(-0.17±0.05)mm,各组间的差异无统计学意义(P＞0.05).结论 后牙区种植牙的解剖冠根比或临床冠根比大小没有对种植体生存率和周围骨垂直高度丧失产生影响,冠根比大的种植体同样可以获得良好的临床效果.     

A 5-year retrospective clinical study of the Dentium implants

PURPOSE

The aim of this retrospective study was to evaluate cumulative survival rate (CSR) of Implantium implants followed for 5 years and association between risk factors and the CSR.

MATERIALS AND METHODS

A total of two hundred forty-nine Implantium Implants System (Dentium, Seoul, Korea) placed in ninety-five patients from 2004 to 2009 were investigated with several identified risk factors (sex, systemic disease, smoking, alchohol, reason of tooth loss, length, arch (maxilla or mandible), replace tooth type (incisor, canine, premolar or molar) Kennedy classification, prosthodontic type, prosthodontic design, opposite dentition, abutment type, occlusal material, occlusal unit, splint to tooth, cantilever, other surgery). Clinical examination (mobility, percussion, screw loosening, discomfort, etc.) and radiographic examination data were collected from patient records including all problems during follow-up period according to protocols described earlier. Life table analysis was undertaken to examine the CSR. Cox regression method was conducted to assess the association between potential risk factors and overall CSR.

RESULTS

Five of 249 implants were failed. Four of these were lost before loading. The 5-year implant cumulative survival rate was 97.37%. Cox regression analysis demonstrated a significant predictive association between overall CSR and systemic disease, smoking, reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The screw related complication was rare. Two abutment screw fractures were found. Another complications of prosthetic components were porcelain fracture, resin facing fracture and denture fracture (n=19).

CONCLUSION

The 5-year CSR of Implantium implants was 97.37%. Implant survival may be dependent upon systemic disease, smoking reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The presence of systemic diseases and combination of other surgical procedures may be associated with increased implant failure.     

短种植体在骨量不足后牙区应用的临床效果评价

目的: 观察短种植体在骨高度不足后牙区种植修复的临床效果。方法: 自2012年1月—12月,选取剩余牙槽骨高度为3~10 mm的后牙缺失病例,共计30例患者植入38颗Bicon短种植体（≤8 mm）。随访4年,检测指标包括X线、临床检查（改良菌斑指数、改良出血指数、探诊深度）以及采用牙列缺损患者种植义齿修复疾病专表（OHIP-I）调查患者的满意度。应用SPSS17.0软件包对数据进行统计学分析。结果: 短种植体存留率、成功率分别为100%、94.7%,总体边缘骨吸收为（0.25±0.65）mm,近中、远中边缘骨水平变化分别为（-0.23±0.74）mm、（-0.27±0.59) mm。冠根比C/I=1.77±0.34,按C/I≤1、12进行分组,各组边缘骨变化无显著差异,且C/I与骨吸收之间无关联。临床检查平均改良菌斑指数为1.08±0.88,出血指数为1.11±0.83,探诊深度为（3.08±1.19）mm。OHIP-I得分为2.66±0.88分,与手术前相比具有显著差异（P<0.01）。结论: 在骨高度不足的后牙区应用短种植体是可行的,其成功率较高且种植体周围软组织健康状况良好。短种植体能够避免复杂手术,减少创伤,缩短治疗时间,患者易于接受且满意度较高。定期复诊及预防性维护对种植义齿的长期稳定十分重要。     

短种植体在后牙区种植修复的临床观察

目的： ITI短种植体在上下颌后牙区的临床观察及效果评价。方法：选择2005年10月至2013年10月间,在我院接受上下颌后牙区短种植体手术治疗的患者26例,共31枚种植体。随访4月-8年,观察指标包括X线片、临床检查,软组织（指标：牙槽骨吸收情况、牙龈指数、探针深度）等。结果：观察期间未发现短种植体出现松动、断裂,种植部位出现疼痛不适等情况,种植体愈合良好。修复后患者咀嚼功能恢复良好,种植体周围软组织健康,患者对短种植体的修复满意。结论：只要严格选择适应症,规范手术操作,短种植体在一定程度上能解决牙槽骨高度不足的问题,避免复杂的外科手术,减少创伤。     

A longitudinal study of the survival of All-on-4 implants in the mandible with up to 10 years of follow-up

BackgroundImmediate-function implants have become an accepted alternative for fixed restoration protocols in edentulous mandibles on the basis of documented high success rates. The All-on-4 concept (Nobel Biocare, Göteborg, Sweden), a surgical and prosthetic protocol for immediate function involving the use of four implants to support a fixed prosthesis in patients with completely edentulous mandibles, represents one of these protocols. The authors conducted a study to document long-term follow-up of the All-on-4 concept.MethodsThis longitudinal study included 245 patients with a total of 980 immediate-function implants (four per patient), all placed in the anterior region, to support fixed full-arch mandibular prostheses. The inclusion criterion was having an edentulous mandible, or a mandible with hopeless teeth, in need of fixed implant restorations.ResultsA total of 21 implants failed in 13 patients, giving cumulative patient-related and implant-related success rates of 94.8 percent and 98.1 percent, respectively, at five years, and 93.8 percent and 94.8 percent, respectively, with up to 10 years of follow-up. The prostheses’ survival rate was 99.2 percent with up to 10 years of follow up.ConclusionsThe results support the conclusion that use of the All-on-4 immediate-function implant concept in completely edentulous mandibles is viable in the long term.Clinical ImplicationsHigh prosthesis survival rates can be achieved by the use of four implants to support a full-arch fixed prosthesis in the mandible.     

口腔种植修复临床效果十年回顾研究

目的评估骨结合种植体应用10年的临床效果。方法1994年8月至2004年8月在北京大学口腔医学院·口腔医院口腔种植中心植入的骨结合种植体共5590枚,其中Branemark种植体161枚,Frialit-2种植体1436枚,IMZ种植体1012枚,Ankylos种植体767枚,Camlog种植体2189枚,Komet种植体25枚。全部种植体均在2004年8月前完成上部结构修复,其中固定修复2314例,活动修复315例,共计2629例患者。平均追踪77·2个月(7~121个月)。观察方法为X线检查和临床检查,采用Wheeler存留标准评估,纳入Kaplan-Meier存留曲线统计。结果种植修复体完成时2624例患者对修复效果满意,5例患者对修复体不满意,重作后4例表示满意,1例表示可以接受。随访中有105例患者共178枚种植体确诊为种植体周围炎。有明确记录的共68枚种植体脱落。10年随访累计修复体松动21件,修复体折断4件,烤瓷冠崩瓷51件。据Wheeler存留标准统计10年存留率为96·7%。结论种植修复患者的满意度高,本组种植体的10年存留率达到96·7%。     

A 10-year prospective study of ITI dental implants placed in the posterior region. I: Clinical and radiographic results

OBJECTIVES: To evaluate the long-term fixture success rate, crestal bone loss and peri-implant soft tissue parameters around ITI dental implants placed in the posterior region of partially edentulous patients. MATERIAL AND METHODS: A total of 192 ITI dental implants were consecutively placed in premolars and molars of 83 partially edentulous patients admitted for treatment at Geneva Dental School. All implants were restored by means of ceramic-to-metal fused fixed partial dentures and single crowns. Patients were followed as part of a prospective longitudinal study focusing on implant success. Surgical, radiographic and clinical variables were collected at the 1-year recall after implant placement and at the most recent clinical evaluation. RESULTS: The mean observation time was 6 years (range 5-10 years). Four implants failed, yielding a 10-year cumulative survival rate of 97.9%. The mean annual crestal bone loss was -0.04+/-0.2 mm. Hollow-cylinder implants displayed more crestal bone loss (-0.13+/-0.24 mm) than hollow-screw implants (-0.02+/-0.19 mm; P=0.032). Clinical parameters such as age, gender, implant length and bone quality did not affect crestal bone levels. Increase in recession depth (P=0.025) and attachment level (P=0.011) were significantly associated with crestal bone loss. CONCLUSIONS: ITI dental implants placed in the posterior jaw demonstrate excellent long-term clinical success. Hollow-cylinder implants seem to display a higher risk for crestal bone loss. Recession depth and attachment levels appear to be good clinical indicators of peri-implant bone loss.     

Marginal bone loss of tissue- or bone-level implants after simultaneous guided bone regeneration in the posterior mandibular region: A retrospective cohort study

The cover image is based on the Original Article Marginal bone loss of tissue- or bone-level implants after simultaneous guided bone regeneration in the posterior mandibular region: A retrospective cohort study by Xiaoting Shen DDS et al., https://doi.org/10.1111/cid.13144 .

     

Complications related to zygomatic implants placement: A retrospective evaluation with 5 years follow-up

This retrospective study assessed zygoma implants in patients treated for upper maxilla extreme atrophy, trauma, cleft palate, or failed reconstruction.The implants were placed using Quad (4 zygoma implants) or mixed (zygoma and conventional implants in premaxilla) surgical technique, with intra-sinus or extra-sinus approach, followed by immediate or deferred loading. Clinical and radiographic evaluations were carried out at 5-year follow-up from loading. Implant survival, symptoms and signs of sinusitis, radiological alterations in terms of mucosal thickening or obliteration of the maxillary sinuses, oroantral communications, and peri-implant soft tissues were examined.A total of 42 patients, with 116 zygoma implants, were included in the study. The cumulative survival rate was 97.41%. One zygomatic bone fracture was assessed. Eight patients reported sinusitis, and two showed oro-antral communications. A comparison between mean pre- and post-operative Lund–Mackay scores showed a statistically significant increase of sino-nasal disease in the post-operative scores (p = 0.0019). Mucositis and gingival recession was observed in 21 and 8 implants respectively. Average recession was 2.52 ± 2.35 mm.According to our results, placement of zygoma implants has proved to be a predictable procedure, with a lower rate of severe complications compared to other treatment options in extreme upper jaw atrophy.     

A retrospective analysis of 1000 consecutively placed implants in private practice

Background:  There have been numerous reports evaluating clinical outcomes of implants placed in institutional settings, but there are few studies relating to implants placed in private practice. The aim of this retrospective study was to analyse the clinical outcomes of 1000 consecutively placed Straumann implants in private specialist periodontal practice.
Methods:  A hand-search of patient records was undertaken to identify 1000 consecutively placed implants. Data extracted included patient demographics, details of implants placed, implant sites, timing of placement after extraction, hard and soft tissue augmentation procedures, loading protocols, type of prostheses and treatment outcomes (implant survival, implant success and complications).
Results:  The majority of implants (71.5 per cent) placed in patients aged 40 to 69, and the majority of patients (88.6 per cent) received 1 or 2 implants. During the period of the study, 9 implants were lost and 45 presented with complications requiring chairside intervention. A life table analysis showed 5 and 10-year cumulative survival rates of 99.2 per cent and 98.4 per cent respectively, and 5 and 10-year cumulative success rates of 93.1 per cent and 90.9 per cent respectively.
Conclusions:  With careful treatment planning and adherence to recommended surgical and prosthetic protocols, high implant survival and success rates can be achieved in a private practice setting.