背景:目前尚不清楚完整的颊骨板是否是在拔牙后立即放置植入物的先决条件。这项为期10年的随机对照试验的目的是比较种植体周围软组织和硬组织参数,美学评级,患者报告对在美学区颊骨缺损≥5mm的拔牙后牙槽立即放置植入物的满意度,以及牙槽脊保留后延迟放置植入物的满意度。
方法:在拔牙后出现牙齿缺损和颊骨缺损≥5mm的患者被随机分配到立即(即时组,n=20)或延迟(延迟组,n=20)植入物放置。两组患者均在植入后3个月进行第二阶段手术和临时修复放置,此后3个月进行最终修复。在10年的随访期间,边缘骨水平(主要结果),颊骨厚度,软组织参数,美学,记录患者报告的满意度.
结果:10年后,即刻组和延迟组的平均边缘骨水平变化为-0.71±0.59mm和-0.36±0.39mm(p=0.063),分别。两组之间的次要结局没有显着差异。
结论:边缘骨水平变化,颊骨厚度,临床结果,美学,和患者立即植入后的满意度,在颊骨缺损≥5mm的拔牙后窝中结合骨增强,与在美学区保留隆脊后延迟植入后的植入物没有统计学差异。
结论:在牙齿衰竭的情况下立即植入植入物对患者来说是一种有利的治疗选择,因为它大大缩短了治疗时间和手术治疗的数量。问题是,是否需要完整的颊骨壁才能立即放置植入物。进行了一项为期10年的研究,对20例上颌额叶区域牙齿衰竭的患者进行了立即植入治疗,并与20例采用更常规的治疗策略的患者进行了比较,在该策略中,首先切除了牙齿,恢复了骨间隙,并在第二步中放置了植入物。经过10年的随访,植入物周围的骨头似乎非常稳定,牙龈是健康的,患者对结果非常满意。两种治疗方法之间没有差异。这样的结果意味着专业人员可以与患者讨论该程序并应用个人的偏好。
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.
CONCLUSIONS: 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.