骨缺损部位的即刻单牙种植:为期 10 年的随机对照试验。

IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE
Henny J A Meijer, Kirsten W Slagter, Barzi Gareb, Diederik F M Hentenaar, Arjan Vissink, Gerry M Raghoebar
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引用次数: 0

摘要

背景:目前还不清楚完整的颊骨板是否是在拔牙后牙槽骨中即刻植入种植体的先决条件。这项为期 10 年的随机对照试验旨在比较种植体周围软组织和硬组织参数、患者对拔牙后牙槽骨美学区颊骨缺损≥5 毫米的即刻种植体植入的美学评价和满意度,以及牙槽嵴保留后的延迟种植体植入的美学评价和满意度:方法:将拔牙后美观区有一颗失败牙且颊骨缺损≥5 mm的患者随机分配为即刻种植(即刻组,n = 20)或延迟种植(延迟组,n = 20)。两组患者均在种植体植入后 3 个月进行第二阶段手术和临时修复体植入,之后 3 个月进行最终修复体植入。在为期 10 年的随访期间,记录了边缘骨水平(主要结果)、颊骨厚度、软组织参数、美观度和患者报告的满意度:结果:10 年后,即刻组和延迟组的平均边缘骨水平变化分别为 -0.71 ± 0.59 毫米和 -0.36 ± 0.39 毫米(p = 0.063)。两组的次要结果无明显差异:即刻种植结合骨增量术植入颊骨缺损≥5 毫米的拔牙后牙槽窝后,边缘骨水平变化、颊骨厚度、临床效果、美学效果和患者满意度与在美学区保留牙脊后延迟植入种植体后的结果无统计学差异。问题是即刻种植是否需要完整的颊骨壁。在一项为期 10 年的研究中,20 名上颌额部牙齿缺损的患者接受了即刻种植治疗,并与 20 名采用更传统治疗策略的患者进行了比较,后者首先拔除缺损的牙齿,恢复骨间隙,然后再植入种植体。经过 10 年的随访,种植体周围的骨质非常稳定,牙龈健康,患者对效果非常满意。两种治疗方法没有任何区别。这样的结果意味着专业人员可以与患者讨论治疗程序,并根据个人喜好进行选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Immediate single-tooth implant placement in bony defect sites: A 10-year randomized controlled trial.

Background: It is unclear whether an intact buccal bony plate is a prerequisite for immediate implant placement in postextraction sockets. The aim of this 10-year randomized controlled trial was to compare peri-implant soft and hard tissue parameters, esthetic ratings of, and patient-reported satisfaction with immediate implant placement in postextraction sockets with buccal bony defects ≥5 mm in the esthetic zone versus delayed implant placement after alveolar ridge preservation.

Methods: Patients presenting a failing tooth in the esthetic region and a buccal bony defect ≥5 mm after an extraction were randomly assigned to immediate (Immediate Group, n = 20) or delayed (Delayed Group, n = 20) implant placement. The second-stage surgery and provisional restoration placement occurred 3 months after implant placement in both groups, followed by definitive restorations 3 months thereafter. During a 10-year follow-up period, marginal bone levels (primary outcome), buccal bone thickness, soft tissue parameters, esthetics, and patient-reported satisfaction were recorded.

Results: The mean marginal bone level change was -0.71 ± 0.59 mm and -0.36 ± 0.39 mm in the Immediate Group and the Delayed Group after 10 years (p = 0.063), respectively. The secondary outcomes were not significantly different between both groups.

Conclusions: Marginal bone level changes, buccal bone thickness, clinical outcomes, esthetics, and patients' satisfaction following immediate implant placement, in combination with bone augmentation in postextraction sockets with buccal bony defects ≥5 mm, were not statistically different to those following delayed implant placement after ridge preservation in the esthetic zone.

Plain language summary: Immediate implant placement in case of a failing tooth is a favorable treatment option for patients because it considerably shortens treatment time and the number of surgical treatments. The question is if an intact buccal bone wall is necessary for immediate implant placement. A 10-year study was performed in which 20 patients with a failing tooth in the frontal region of the upper jaw were treated with immediate implant placement and were compared with 20 patients in whom a more conventional treatment strategy was followed in which the failing tooth was first removed and the bone gap restored and the implant placed in a second step. After a 10-year follow-up period, it appeared that the bone around the implant was very stable, gums were healthy, and patients were very satisfied with the result. There was no difference between the two treatment procedures. Such results mean that professionals can discuss the procedure with the patient and apply the individual's preference.

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来源期刊
Journal of periodontology
Journal of periodontology 医学-牙科与口腔外科
CiteScore
9.10
自引率
7.00%
发文量
290
审稿时长
3-8 weeks
期刊介绍: The Journal of Periodontology publishes articles relevant to the science and practice of periodontics and related areas.
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