Immediate loading of two unsplinted mandibular implants in edentulous patients with an implant-retained overdenture: an observational study over two years.
Immediate loading of two unsplinted mandibular implants in edentulous patients with an implant-retained overdenture: an observational study over two years.
复制标题
在种植体固位覆盖义齿的无牙颌患者中立即装载两个无夹板下颌种植体：一项为期两年的观察性研究。
DOI：
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发表时间：
2012
期刊：
影响因子：
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通讯作者：
C. Marinello
中科院分区：
文献类型：
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作者：
Adrian E Büttel;D. Gratwohl;P. Sendi;C. Marinello
目标
通过覆盖义齿的方式立即加载两个无夹板的下颌种植体可能是一种可行且成本效益高的治疗方案，可以改善患者与口腔健康相关的生活质量。因此，我们进行了一项前瞻性观察研究，以评估无牙患者在即刻加载方案后的种植体存活率和患者满意度。
材料和方法
20例无牙颌患者接受了两种孔间种植体(Strutaann Standard种植体，长度为12 mm)。种植体植入后，立即在种植体上放置直径为2.25 mm的球形附着体，并将各自的基质直接结合到现有的全口义齿中。在植入后1周、1个月、3个月、6个月、1年和2年进行临床召回。评估以下临床参数：牙龈出血指数(GBI)、视觉菌斑指数(VPI)和软组织过度生长。此外，在基线、6个月和2年后，我们还使用全景X线片评估放射性骨水平变化(RBLC)，并使用视觉模拟评分评估患者满意度。
结果
两年观察期内未发生种植失败，成活率为100%。术后2年平均RBLC为0.67 mm(95%可信区间[95%CI]：0.47~0.86 mm)。两年后GBI和VPI分别为24(95%CI：9~38)%和36(95%CI：19~53)%。软组织过度生长两年后平均1.6 mm(95%CI：1.1~2.1)。在多变量回归模型中，平均≥为50%的患者的RBLC增加(-0.6 mm，p=0.007)。患者评分较高，总体满意度较高。患者总体满意度在植入前为5.2(95%可信区间：2.1-8.5)，两年后为9.5(95%可信区间：9.1-10)。
结论
在覆盖义齿患者中，使用球状附着体立即加载两个无夹板的孔间种植体是一种临床上可行的治疗方案，可导致高存活率和口腔健康相关的生活质量。
OBJECTIVES
Immediate loading of two unsplinted mandibular implants by means of an overdenture may be a viable and cost-effective treatment option to improve the patient's oral health-related quality of life. We therefore conducted a prospective observational study to estimate implant survival and patient satisfaction after an immediate loading protocol in edentulous patients.
MATERIALS AND METHODS
Twenty edentulous patients who received two interforaminal implants (Straumann Standard implant, length 12 mm) were included in our study. Immediately after implant placement, ball attachments with a diameter of 2.25 mm were placed on the implants and the respective matrices were directly incorporated in the existing complete denture. Clinical recalls were scheduled 1 week, 1, 3, 6 months, and 1 and 2 years after implant placement. The following clinical parameters were assessed: gingival bleeding index (GBI), visual plaque index (VPI), and soft tissue overgrowth. In addition, we also assessed radiological bone level change (RBLC) using panoramic radiographs, and patient satisfaction using a visual analogue scale at baseline, after 6 months and 2 years.
RESULTS
No implant failures occurred during the 2-year observation period, resulting in a survival rate of 100%. The mean RBLC was 0.67 mm (95% Confidence Interval [95% CI]: 0.47-0.86 mm) two years after surgery. The GBI and VPI after two years were 24 (95% CI: 9-38)% and 36 (95% CI: 19-53)%, respectively. Soft tissue overgrowth was 1.6 mm (95% CI: 1.1-2.1) on average after two years. In a multivariate regression model, patients with a GBI ≥50% on average showed an increased RBLC (-0.6 mm, p = 0.007). High patient ratings were recorded for overall satisfaction. Overall patient satisfaction measured on a scale between one and ten was 5.2 (95% CI: 2.1-8.5) before implant placement and 9.5 (95% CI: 9.1-10) after 2 years.
CONCLUSION
Immediate loading of two unsplinted interforaminal implants in overdenture patients using ball attachments is a clinically viable treatment option that leads to a high survival rate and oral health-related quality of life.