Immediate implant placement combined with maxillary sinus floor elevation utilizing the transalveolar approach and nonsubmerged healing for failing teeth in the maxillary molar area: A randomized controlled trial clinical study with one-year follow-up
Immediate implant placement combined with maxillary sinus floor elevation utilizing the transalveolar approach and nonsubmerged healing for failing teeth in the maxillary molar area: A randomized controlled trial clinical study with one-year follow-up
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DOI：
10.1111/cid.12783
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发表时间：
2019-06-01
影响因子：
3.6
通讯作者：
Yang, Jianjun
中科院分区：
文献类型：
--
作者：
Liu, Hanqing;Liu, Renzhang;Yang, Jianjun
背景在以往的研究中，磨牙区即刻种植体植入已被广泛应用。目的探讨上颌磨牙区牙体缺损即刻种植联合上颌窦底提升非埋植修复的临床效果及可行性。材料与方法选择需要种植修复的上颌磨牙区失败牙的患者。患者被随机分为两组：即刻种植体植入联合上颌窦底提升，采用经牙槽入路和非浸没式愈合（试验组）或延迟种植体植入联合上颌窦底提升，采用经牙槽入路和非浸没式愈合（对照组）。结局标准为种植体成功率、锥形束计算机断层扫描（CBCT）数据和使用视觉模拟量表（VAS）进行的主观满意度调查结果。结果所有种植体植入后初期稳定性良好。1年随访时种植体存活率为100%。永久修复时，试验组颊侧牙槽骨平均水平收缩率（W1）（0.65 +/- 0.12 mm）和对照组（1.23 ± 0.32 mm）具有统计学显著性（P < .0001）;然而，在腭侧没有观察到统计学显著差异（P = .515）（0.3 +/- 0.10 mm vs 0.28 +/- 0.08 mm）。实验组间颊侧牙槽骨垂直吸收（H1）的差异（0.60 +/- 0.18 mm）和对照组（1.53 ± 0.19 mm）具有统计学显著性（P < .0001），但在腭牙槽骨减少方面没有统计学显著差异（P = .190）（0.24 +/- 0.12 mm vs 0.29 +/- 0.13 mm）。加载1年后，试验组和对照组的垂直或水平变化（W2，H2）无统计学显著差异（P > 0.05）。两组患者满意度相似（8.36 +/- 1.01 vs 8.14 +/- 1.35），组间差异无统计学意义（P = 0.638）。结论上颌磨牙区即刻种植联合上颌窦底提升，采用经牙槽骨入路，非埋植愈合，是可行的，临床效果满意。
Background In previous studies, immediate implant placement in molar sites has been widely applied. Purpose To study the clinical effect and feasibility of immediate implant placement combined with maxillary sinus floor elevation utilizing the transalveolar approach and nonsubmerged healing for failing teeth in the maxillary molar area. Material and Methods Patients who required implantation surgry to replace a failing tooth in the maxilla molar region were selected. Patients were randomized into two groups: immediate implant placement combined with maxillary sinus floor elevation utilizing the transalveolar approach and nonsubmerged healing (test group) or delayed implant placement combined with maxillary sinus floor elevation utilizing the transalveolar approach and nonsubmerged healing (control group). The outcome criteria were the success rates of implants, Cone Beam Computer Tomography (CBCT) data and results of the subjective satisfaction survey performed with a visual analog scale (VAS). Results All implants had good initial stability after implantation. The survival rate of implants was 100% at 1-year follow-up. At the time of permanent restoration, the differences in average horizontal shrinkage of alveolar bone (W1) on the buccal side between the test group (0.65 +/- 0.12 mm) and the control group (1.23 +/- 0.32 mm) were statistically significant (P < .0001); however, no statistically significant difference (P = .515) was observed on the palatal side (0.3 +/- 0.10 mm vs 0.28 +/- 0.08 mm). The difference in vertical resorption of alveolar bone (H1) on the buccal side between the test group (0.60 +/- 0.18 mm) and the control group (1.53 +/- 0.19 mm) was statistically significant (P < .0001), but no statistically significant difference (P = .190) in the reduction of palatal alveolar bone (0.24 +/- 0.12 mm vs 0.29 +/- 0.13 mm) was observed. After 1-year loading, no statistically significant difference (P > .05) in vertical or horizontal changes (W2, H2) were identified in the test group or control group. Patient satisfaction in both groups was similar (8.36 +/- 1.01 vs 8.14 +/- 1.35), and the difference between groups was not statistically significant (P = .638). Conclusion Immediate implant placement combined with maxillary sinus floor elevation utilizing the transalveolar approach and nonsubmerged healing is feasible for the maxillary molar area, and the clinical effect is satisfactory.