Maintenance of marginal bone support and soft tissue esthetics at immediately provisionalized OsseoSpeed™ implants placed into extraction sites: 2-year results
Maintenance of marginal bone support and soft tissue esthetics at immediately provisionalized OsseoSpeed™ implants placed into extraction sites: 2-year results
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DOI：
10.1111/clr.12069
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发表时间：
2014-02-01
影响因子：
4.3
通讯作者：
Wagner, Wilfried
中科院分区：
文献类型：
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作者：
Noelken, Robert;Neffe, Bettina Anna;Wagner, Wilfried
背景种植体植入拔牙窝的目的是维持种植体周围的硬组织和软组织结构，并支持自然和美观的轮廓。与延迟植入相比，立即植入种植体的主要优点如下：治疗时间缩短，疗程次数减少，因此侵入性更小。本研究通过对20例上颌骨前部即刻暂时性种植种植体植入后的临床表现(存活率、边缘骨水平和粉色美学评分[PES])进行观察。方法20例患者共植入37颗种植体，即刻植入不同大小的面骨缺损性或非缺损性拔牙窝。应用了一种无瓣的程序，种植体立即被临时安置在没有咬合接触的牙冠上。种植体表面与面骨之间的间隙或前牙槽突轮廓用自体骨碎片移植。种植体直径分别为3.5、4.0、4.5和5.0，长度为11~17 mm。在研究过程中，对每个种植体的近端边缘骨水平、面部骨壁厚度、种植体成功率和PES进行评估。结果1例患者在假体交付后没有继续研究，其余34个种植体在最后一次随访时仍然有效(存活率：100%)。随访期12~40个月，平均27个月。最后一次随访时，种植体肩部边缘骨高度平均为-0.10.55 mm(-1.25~1.47 mm)。末次随访时平均PES评分为11.3+/-1.8(范围6-14)。在78%的患者中，PES被保留或甚至改善。结论成功率、边缘骨水平和美学结果表明，在至少12个月的随访后，立即放置和暂存化的OsseoFast种植体保留了边缘骨高度的原则证据。使用即刻种植体植入、即刻重建和即刻预置化技术，即使是面部骨缺失的种植体部位也可以成功地治疗，获得良好的美学效果。
BackgroundPlacement of implants into extraction sockets targets the maintenance of peri-implant hard and soft tissue structures and the support of a natural and esthetic contour. The main advantages of immediate implant insertion in comparison with delayed implant placement protocols are as follows: a reduced treatment time, less number of sessions, and, thus, the less invasive procedure. This study examines the clinical performance (survival rate, marginal bone levels and Pink Esthetic Score [PES]) of OsseoSpeed implants placed into extraction sockets with immediate provisionalization in the anterior maxilla after a follow-up of at least 12months.MethodsTwenty patients received a total number of 37 OsseoSpeed implants which were immediately inserted into extraction sockets with or without facial bone deficiencies of various dimensions. A flapless procedure was applied, and the implants were immediately provisionalized with temporary crowns without occlusal contacts. Facial gaps between implant surface and facial bone or the previous contour of the alveolar process were grafted with autogenous bone chips. Implants in diameters 3.5, 4.0, 4.5, and 5.0 with lengths of 11-17mm were used in the study. During the course of the study, interproximal marginal bone levels, the thickness of the facial bony wall, implant success rate according to the criteria established by Buser, and the PES were assessed per implant.ResultsOne patient with three implants did not continue the study after prosthesis delivery, the remaining 34 implants were still in function at the final follow-up (survival rate: 100%). The mean follow-up period was 27months (range, 12-40months). Marginal bone height at the level of the implant shoulder averaged -0.10.55mm (range, -1.25 to 1.47mm) at the final follow-up. The mean PES ratings were 11.3 +/- 1.8 (range, 6-14) at the final follow-up. In 78% of the patients, the PES was preserved or even improved.ConclusionsSuccess rates, marginal bone levels, and esthetic results suggest proof of principle for the preservation of marginal bone height at immediately placed and provisionalized OsseoSpeed implants after a follow-up of at least 12months. Even implant sites with facial bony deficiencies can be successfully treated with a favorable esthetic outcome using the immediate implant insertion, immediate reconstruction, and immediate provisionalization technique.