“All-on-4”即刻种植修复并发症8年追踪分析

Complications of “All-on-4” immediate function treatment:an 8-year retrospective study

目的：分析牙列缺失病例中＂All-on-4＂种植即刻修复的并发症发生情况,探讨其原因与解决方法。方法：2006年12月至2014年12月于澳门接受＂All-on-4＂种植即刻修复治疗的21例患者,当中上颌牙列缺失1例,下颌牙列缺失19例,全口牙列缺失1例,均在手术当天制作并戴入临时修复体,术后3-6个月复诊制作最终修复体,共完成22件临时修复体及22件最终修复体。戴入后平均追踪39个月（5~92个月）,观察种植体与修复体的功能状态及并发症的发生情况,并对数据进行分析。结果：本研究中,88枚种植体及22件最终修复体至最后一次复查情况稳定,种植体存活率100%,修复体存活率100%;21位患者当中,9位患者曾发生并发症,并发症发生率42.9%。结论：＂All-on-4＂在牙列缺失病例治疗效果的中短期观察中,虽然并发症的发生率甚高,但均为可处理而不影响修复体功能的事件,临床使用上仍能获得满意的效果,是一种可行的方法。

Objective： To observe the clinical complications of ＂All-on-4＂ immediate function treatment, analyze and discuss the possible reasons for the complications and try to find a clinical solution for those complications. Methods： Retrospective study was conducted among 21 maxillary or mandible edentu- lous patients who received ＂All-on-4＂ treatment in Macao since December 2006 to December 2014. A- mong these 21 patients, there are 1 case of maxillary edentulous, 19 cases of mandible edentulous and 1 case of both maxillary and mandible edentulous. All patients received provisional prostheses for func- tion on the day of surgery. Definitive prostheses were delivered to patients after 3-6months post opera- tion and follow-up visits were performed up to 92 months （average 39 months） after placement of definitive prostheses. Result： Twenty-one patients participated in this study and 22 complete-arch im- mediately loaded prostheses（2 maxillary and 20 mandibular）, each supported by four implants （in total 88 implants）, were placed. All implants and prostheses stayed in good condition until the last follow-up visit throughout the study period. Implant survival rate was 100%, prosthesis survival rate was 100%. Complications occurred in 9 cases and accumulative complication rate was 42.9%. Conclusion： Although some of the complications are inevitable, most of them are minor problems and will not lead to failure of implants and prostheses if they are well treated. ＂All-on-4＂ is a practical treatment concept with satisfying outcomes in short and medium term.