NobelSpeedy种植体即刻修复的临床研究

Clinical evaluation of immediately loaded NobelSpeedy implants in partially edentulous patients

目的:本研究拟对牙列缺损患者应用NobelSpeedy Replace种植体即刻修复进行临床评估,评价其的短期存留率及种植体周围骨吸收情况,初步探讨可能影响牙列缺损即刻修复成功的相关因素。方法:选择2008年6月至2008年12月于中山大学光华口腔医学院o附属口腔医院种植科就诊的牙列缺损患者32例,其中男性22例,女性10例。手术采用一期手术即刻临时修复方案,种植体植入扭矩大于35Ncm且不超过45Ncm,手术当天戴入临时义齿,术后3个月永久修复。即刻修复后3个月、6个月、1年复诊。记录各个时期的种植体存留率、边缘骨水平等临床指标。采用描述性统计评价各个指标在不同随访时期的差异。结果:32例患者共植入52枚即刻修复的NobelSpeedy种植体,累积观察6-12个月。两例单牙缺失患者中共2枚种植体失败脱落,累积存留率为96.2%。其中单牙即刻修复存留率为88.2%,多牙即刻修复存留率为100%。所有种植体平均植入扭矩为41.1±4.7Ncm。负载3个月、6个月和12个月后的种植体周围平均骨吸收为分别为0.64mm、0.68mm和0.69mm。讨论:即刻修复应选择咬合正常、骨质优良、骨量充足的患者及自攻性较强的种植体保证种植体初期稳定性以限制过度微动。NobelSpeedy种植体优异的骨挤压性能和微螺纹设计使其适用于多种骨质条件下即刻负载的应用。然而,单牙即刻修复因没有种植体间的相互稳定作用,失败的风险会更高。结论:NobelSpeedy Replace种植体即刻修复可以获得满意的短期存留率。单牙缺失即刻修复的风险高于多牙缺失。严格的病例选择,合理的咬合调整和密切的术后随访是保证即刻修复成功的关键。

Purpose:The aim of the study was to prospectively evaluate the clinical performance of NobelSpeedy Replace implant in the rehabilitation of partial edentulous and in combination with an immediate restoration protocol.MATERIAL & METHODS:Thirty-two subjects(22 males,10 females),who required partially edentulous rehabilitation,were enrolled in the study.Implant installation was followed by one-stage procedure of immediate implant loading.The final tightening torque was between 35 N·cm and 45 N·cm.The implant was immediately restored with a provisional crown without occlusal contacts.A definitive prosthesis was delivered to each patient after 3 months.Cumulative survival rate and marginal bone changes were recorded at 3-,6-and 12-month follow-up visits at all sites.Data were reported using descriptive statistics.Results:A total of fifty-two NobelSpeedy implants were inserted,observed for 6-12 months.Two implants failed in two patients,rendering a cumulative clinical survival rate of 96.2%(88.2% for single-tooth restorations and 100% for fixed partial prostheses).The mean implant insertion torque was 41.1 ± 4.7 Ncm.The peri-implant marginal bone changes were on average 0.64mm,0.68mm and 0.69mm during the first 3-,6-and 12-month of loading.Discussions:Avoiding excessive micro-motion is the key point to gain osseointegration between bones and the immediate loaded implants.The NobelSpeedy implants achieve excellent initial stability in all bone qualities owing to the new designed figures and micro-grooves,which more applicable to immediate function.However,the risk of failure is higher in single tooth replacement because there is no stable interaction between implants.Conclusions:The results of the present short-term study indicate that partially edentulous jaws can be treated with acceptable survival rate using NobelSpeedy Replace implants utilizing an immediately loaded protocol,and that favorable marginal bone levels can be maintained.