背景:该研究的目的是通过使用解剖引导方法(AGA)的四核zygoma方案(QZP)治疗严重萎缩性上颌骨的长期临床结果和并发症。
方法:这是一项回顾性队列研究,对所有患有严重萎缩性上颌骨缺失且双侧前区和后区骨高度和宽度不足的连续患者,他们在2006年5月至2021年12月期间接受了QZP的康复治疗。所有患者随访至少1年。所有颧骨植入物(ZIs)均由同一外科医生放置。研究的主要终点是植入物存活率。次要终点是植入成功率,假体成功率,并发症,和口腔健康相关的生活质量使用OHIP-14问卷。
结果:共有56名患者(男性16名,女性40名)和224个ZIs(诺贝尔生物保健,n=204;Straumann,n=16;南方种植体,n=4)的放置包括平均随访期8.8±3.9年(范围,1.2-17.0)。生存率(成功率)为97.7%。四名患者中有五个ZI失败。植入物放置和失败之间的平均时间为8.6年(范围,0.5-13.3)。所有患者立即接受丙烯酸假体的负荷。最终假体的成功率为98.2%。42例患者接受后悬臂梁修复固定的确定性假体。局部口面部炎症(35.7%)和鼻窦炎(12.5%)是最常见的并发症,发生在平均随访10.0(范围,4.2-14.9)和10.3(范围,4.3-16.2)年,分别。在48名患者中,OHIP-14问卷的平均得分为1.7±2.6,随访期为9.0±4.1年.
结论:使用QZP对严重萎缩性无牙颌上颌骨的康复已显示出可预测的长期高生存率。立即加载协议的实施在通过跨弓稳定来稳定ZI方面提供了潜在的好处。此外,在重建中使用后悬臂可以通过分布良好的ZIs有效地建立功能闭塞,消除了额外的植入物放置的需要。
BACKGROUND: The objective of the study was to provide long-term clinical outcomes and complications in the severely atrophic edentulous maxillae treated by means of the quad zygoma protocol (QZP) using the Anatomy-Guided Approach (AGA).
METHODS: This was a retrospective cohort study of all consecutive patients with severely atrophic edentulous maxilla and insufficient bone height and width in the anterior and posterior regions bilaterally, who underwent rehabilitation with the QZP between May 2006 and December 2021. All patients were followed for at least 1 year. All zygomatic implants (ZIs) were placed by the same surgeon. The primary endpoint of the study was the implant survival rate. Secondary endpoints were implant success rate, prosthesis success rate, complications, and Oral Health-Related Quality of Life using the OHIP-14 questionnaire.
RESULTS: A total of 56 patients (men 16, women 40) with 224 ZIs (Nobel Biocare, n = 204; Straumann, n = 16; Southern Implant, n = 4) placement were included with a mean follow-up period 8.8 ± 3.9 years (range, 1.2-17.0). The survival (success) rate was 97.7%. Five ZIs in four patients failed. The mean time between implant placement and failure was 8.6 years (range, 0.5-13.3). All patients received immediate loading with acrylic prosthesis. The successful rates for the definitive prosthesis were 98.2%. Forty-two patients received posterior cantilever for rehabilitation of fixed definitive prosthesis. Local orofacial inflammation (35.7%) and Sinusitis (12.5%) were the most common complications, occurring at a mean follow-up of 10.0 (range, 4.2-14.9) and 10.3 (range, 4.3-16.2) years, respectively. In 48 patients, the mean score of the OHIP-14 questionnaire was 1.7 ± 2.6 with the follow-up period of 9.0 ± 4.1 years.
CONCLUSIONS: The rehabilitation of severely atrophic edentulous maxilla using the QZP has shown a predictable and high survival rate in the long term. The implementation of an immediate loading protocol offers potential benefits in stabilizing ZIs with cross-arch stabilization. Moreover, the use of a posterior cantilever in reconstruction can effectively establish functional occlusion through well-distributed ZIs, eliminating the need for additional implant placement.