Maxilla augmentation with calvarial bone: immediate or delayed dental implant placement?

F. Konik , G.M. Raghoebar , T.F. Putters , A. Vissink , K. Delli , J. Schortinghuis
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Abstract

Introduction

In the severely atrophic maxilla, an augmentation is required to allow placement of dental implants to support the denture. Since 2010 calvarial bone blocks were used to augment the maxilla. Dental implants are placed after 4 months healing time, or immediate at the time of augmentation. A retrospective study was done to measure peri-implant bone loss, implant loss and influencing factors.

Methods

A retrospective cohort study was set up including patients that were treated from 2010 to 2020. Patient factors (age, sex, smoking, medication use), surgery factors (delayed or immediate implantation, location of implant) and radiological follow-up (peri implant bone loss, implant loss) were scored. A GEE (Generalized Estimated Equations) statistical analysis was performed to find factors influencing outcome.

Results

A total of 111 patients (47 male; 64 female) received 508 implants. Follow-up was 4.6 ± 2.3 years. Mean peri-implant bone loss in 26 patients with a delayed approach was 0,34 ± 0,73 mm and in 85 patients with combined augmentation and immediate implantation 0,57 ± 0,88 mm (p < 0,001). Implant success was 99 % in the delayed group, and 92 % in the immediate group. Age, smoking, status of mandible (edentate/(partially) dentate) and implant location did not influence peri-implant bone loss.

Conclusion

When a severely athrophic maxilla is augmented with calvarial bone, immediate implant placement seems a viable option with low long-term peri-implant bone loss, and the advantage to reduce total treatment time and the need for an extra surgical procedure.
上颌骨颅骨隆胸:即刻还是延迟种植牙?
对于严重萎缩的上颌,需要进行隆胸以植入牙种植体来支撑义齿。自2010年以来,颅骨块被用于增加上颌骨。牙种植体在愈合4个月后放置,或在隆胸时立即放置。回顾性研究种植体周围骨丢失、种植体丢失及其影响因素。方法建立回顾性队列研究,纳入2010 ~ 2020年接受治疗的患者。对患者因素(年龄、性别、吸烟、用药)、手术因素(延迟或立即种植、种植体位置)和放射学随访(种植体周围骨质流失、种植体流失)进行评分。采用GEE(广义估计方程)统计分析找出影响结果的因素。结果111例患者(男47例,女64例)共种植体508枚。随访4.6±2.3年。26例延迟入路患者种植体周围骨丢失平均为0.34±0.73 mm, 85例联合隆胸和即刻种植患者种植体周围骨丢失平均为0.57±0.88 mm (p < 0.001)。延迟组种植成功率为99%,即刻组为92%。年龄、吸烟、下颌骨状态(齿状/(部分)齿状)和种植体位置对种植体周围骨丢失没有影响。结论对严重萎缩的上颌骨进行颅骨增殖术时,即刻种植体置入术是一种可行的选择,种植体周围长期骨质流失少,且具有缩短总治疗时间和减少额外手术的优点。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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