All-on-4种植固定修复的1~6年临床疗效观察回顾性研究

Clinical outcome evaluation of All-on-4 fixed implant immediate rehabilitation:1-6 years retrospective study

目的 回顾性研究分析无牙颌患者行All-on-4即刻负重种植修复技术的临床效果。方法 本研究共纳入2013年11月—2019年8月期间完成的30例All-on-4患者,共植入144颗种植体,对该治疗方案下1~6年种植体、修复体的留存率,种植体边缘骨吸收情况,修复体机械并发症及患者满意度和生活质量评分进行归纳分析。结果 30例患者种植体留存率100%,修复体留存率100%。种植术后随访的各个时间段,垂直种植体和倾斜种植体的边缘骨吸收量结果差异无统计学意义,边缘骨吸收在种植术后2~3年内趋于稳定,之后随访期内骨吸收量没有显著的变化。有13个修复体发生过1次或多次机械并发症,占43.3%(13/30),包括临时修复体折裂,修复体的基台螺丝折断、固位螺丝松动、修复体出现1次或多次崩瓷等。患者满意度和口腔健康量表得分方面,患者对修复完成后修复体的舒适稳定性、心理社交及咀嚼恢复满意度较高;而对于美观、修复后疼痛、发音效果、口腔卫生维护的满意度相对较低。结论 无牙颌患者采用All-on-4即刻种植修复技术的中短期临床效果确切可靠,该治疗的技术要点对修复效果的影响需要更多长期高质量的大样本临床观察。

Objective To evaluate the clinical outcomes of All-on-4 immediate loading implant restorations in edentulous patients. Methods A total of 30 All-on-4 patients with 144 implants who completed the treatment between November 2013 and August 2019 were included in this study. The 1-6 years outcome measurements, including survival rate of the implants and prostheses, marginal bone resorption of the implants, mechanical complications of the prostheses, patient satisfaction and quality of life scores were analyzed after implantation. Results Among the 30 patients, the implant survival rate and the restoration survival rate was 100%. There was no statistical difference in the comparison results of the marginal bone loss between axial and tilted implants in each time period. The bone loss stabilized within 2 or 3 years after implantation, and there was continuous bone loss during the follow-up period, but there was no significant change in bone resorption. One or more mechanical complications occurred in 13 restorations, accounting for 43.3%(13/30)of the total restorations, including temporary restorations fractured, abutment screws of restorations broken, retention screws loose, and restorations had one or more fractures. In terms of stability, psycho-social and chewing recovery, patient satisfaction score was relatively high;while for aesthetics, pain, and pronunciation effects, patient satisfaction score was relatively low. Conclusion The short-term clinical outcomes of All-on-4 immediate loading implant restoration technology in edentulous patients are reliable. However, more long-term clinical studies with high-quality large samples need to be conducted.