比较All-on-4种植修复中倾斜种植体与轴向种植体临床效果的5年回顾性研究

目的 通过回顾性研究分析,比较All-on-4种植修复中倾斜种植体与轴向种植体的5年临床效果。方法 回顾2013年10月—2015年10月在南京大学医学院附属口腔医院种植科完成上颌和/或下颌All-on-4种植修复治疗的26例患者,共植入120颗种植体,其中倾斜种植体60颗,轴向种植体60颗。术后行种植体支持式即刻修复,3~6个月后行最终修复。对患者进行随访,对倾斜与轴向种植体、不同倾斜角度的倾斜种植体以及上、下颌种植体之间的种植体存留率、种植体边缘骨吸收以及并发症发生率进行统计分析。结果 ①All-on-4种植修复中种植体总体5年存留率为98.33%,倾斜种植体5年存留率为96.67%,轴向种植体5年存留率为100%,两者之间差异无统计学意义（P=0.496）。②负载5年后,倾斜种植体边缘骨吸收量平均(1.16±0.98)mm,轴向种植体边缘骨吸收量平均(1.11±0.76)mm,两者边缘骨吸收量差异无统计学意义（P=0.709）。③倾斜与轴向种植体之间并发症发生率无统计学差异。结论 在All-on-4种植修复中,倾斜种植体具有与轴向种植体相似的较高的5年种植体存留率以及较为稳定的种植体边缘骨水平维持。All-on-4种植修复中远端倾斜种植体的应用具有良好的负载5年临床效果。

Comparison of clinical outcomes of tilted implants and axial implants in All-on-4 implant restoration:A 5-year retrospective study

Objective To compare the 5-year clinical outcomes between tilted implants and axial implants in All-on-4 implant restoration through a retrospective study.Methods A total of 26 patients who accepted maxillary and/or mandibular All-on-4 rehabilitation treatment in the Department of Oral Implantology,Nanjing Stomatological Hospital,Medical School of Nanjing University from October 2013 to October 2015 were followed up.A total of 120 implants were included,including 60 tilted implants and 60 axial implants.Immediate fixed rehabilitation supported by implants was performed after operation,and final rehabilitation was performed 3-6 months later.After 5 years of follow-up,the differences of implant survival rate,marginal bone level changes and the incidence of complications between tilted and axial implants,among tilted implants with different angles and between implants in upper and lower jaws were statistically analyzed.Results(1)The overall 5-year implant survival rate of implants in All-on-4 implant restoration was 98.33%(tilted implants 96.67%,axial implants 100%).There was no significant difference between the two groups(P=0.496).(2)After 5 years of loading,the average marginal bone resorption of inclined implant was(1.16±0.98)mm,and that of axial implant was(1.11±0.76)mm.There was no significant difference in marginal bone level changes between the two groups(P=0.709).(3)There was no significant difference in the incidence of complications between tilted and axial implants.Conclusion In All-on-4 implant rehabilitation,tilted implants have a high 5-year implant survival rate and a relatively stable marginal bone level,which is similar to that of axial implants.The application of distal tilted implants has satisfactory 5-year clinical outcomes.