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首页> 外文期刊>Journal of clinical periodontology >Oral rehabilitation with implant-supported fixed partial dentures in periodontitis-susceptible subjects.
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Oral rehabilitation with implant-supported fixed partial dentures in periodontitis-susceptible subjects.

机译：在易患牙周炎的受试者中进行植入物支持的固定局部义齿的口腔修复。

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Wennstrom J L, Ekestubbe A, Grondahl K, Karlsson S, Lindhe J: Oral rehabilitation with implant-supported fixed partial dentures in periodontitis-susceptible subjects. J Clin Periodontol 2004; 31: 713-724. doi: 10.1111/j.1600-051X.2004.00568.x. Copyright Blackwell Munksgaard, 2004. Abstract Background: Comparatively few studies with at least 5 years of follow-up are available that describe the use of implants in prosthetic rehabilitation of partially edentulous patients. Randomized, controlled clinical studies that evaluated the effect of different surface designs of screw-shaped implants on the outcome of treatment are also sparse. Objective: To determine, in a prospective randomized, controlled clinical trial, the outcome of restorative therapy in periodontitis-susceptible patients who, following basic periodontal therapy, had been restored with implants with either a machined- or a rough-surface topography. Material and Methods: Fifty-one subjects (mean age, 59.5 years), 20 males and 31 females who, following treatment of moderate-to-advanced chronic periodontitis, required implant therapy for prosthetic rehabilitation were recruited. Seventeen of the patients were current smokers. Following the active treatment, all subjects were included in an individually designed maintenance program. A total of 56 fixed partial dentures (FPDs) and a total of 149 screw-shaped, and self-tapping implants (Astra Tech(R) implants) - 83 in the maxilla and 66 in the mandible - were installed in a two-stage procedure. Each patient received a minimum of two implants and by randomization every second implant that was installed had been designed with a machined surface and the remaining with a roughened Tioblast(R) surface. Abutment connection was performed 3-6 months after implant installation. Clinical and radiographical examinations were performed following FPD connection and once a year during a 5-year follow-up period. The analysis of peri-implant bone-level alterations was performed on subject, FPD and implant levels. Results: Four patients and four FPDs were lost to the 5 years of monitoring. One implant (machined surface) did not properly integrate (early failure), and was removed at the time of abutment connection. Three implants were lost during function and a further eight implants could not be accounted for at the 5-year follow-up examination. The overall failure rate at 5 years was 5.9% (subject level), 5.3% (FPD level) and 2.7% (implant level). Radiographic signs of loss of osseointegration were not found at any of the implants during the 5-year observation period. During the first year in function there was on average 0.33 (SD, 0.61) mm loss of peri-implant marginal bone on the subject and FPD levels and 0.31 (0.81) mm on the implant level. During the subsequent 4 years, the peri-implant bone-level alterations were small. The calculated annual change in peri-implant bone level was -0.02 (0.15) on subject and FPD levels and -0.03 (0.20) on the implant level. Thus, the mean total bone-level change over the 5-year interval amounted to 0.41 mm on all three levels of analysis. In the interval between baseline and 5 years, the machined and the Tioblast(R) implants lost on average 0.33 and 0.48 mm, respectively (p>0.05). Conclusion: The present randomized, controlled clinical trial that included partially edentulous periodontitis-susceptible subjects demonstrated that bone loss (i) during the first year of function as well as annually thereafter was small and (ii) did not vary between implants with machined- or rough-surface designs.
机译：Wennstrom J L，Ekestubbe A，Grondahl K，Karlsson S和Lindhe J：在易患牙周炎的受试者中用种植体支持的固定局部义齿进行口腔修复。 J Clin Periodontol 2004; 31：713-724。 doi：10.1111 / j.1600-051X.2004.00568.x。版权所有Blackwell Munksgaard，2004年。摘要背景：至少有5年的随访研究表明，在部分缺牙患者的假体修复中使用植入物的情况相对较少。随机，对照的临床研究也很少，这些研究评估了螺旋形植入物的不同表面设计对治疗结果的影响。目的：在一项前瞻性随机对照临床试验中，确定在易患牙周炎的患者中进行恢复性治疗的结果，这些患者在进行基本牙周治疗后，已通过机械或粗糙表面形态的植入物进行了修复。材料与方法：招募了51名受试者（平均年龄59.5岁），20名男性和31名女性，他们接受了中度至高级的慢性牙周炎的治疗，需要假体康复的植入治疗。其中有17名患者是目前吸烟者。积极治疗后，所有受试者均纳入单独设计的维护计划中。分两阶段安装了总共56个固定局部义齿（FPD）和总共149个螺旋形自攻植入物（Astra Tech（R）植入物）–上颌骨83个，下颌骨66个–程序。每个患者至少接受两个植入物，并且通过随机分配，安装的每个第二个植入物的表面都经过机械加工，其余的表面均经过了粗糙处理。种植体安装后3-6个月进行基台连接。在进行FPD连接后并在5年的随访期内每年进行一次临床和射线照相检查。对受试者，FPD和植入物水平进行了植入物周围骨水平变化的分析。结果：监测的5年中丢失了4例患者和4例FPD。一个植入物（机加工表面）未正确整合（早期破坏），并且在基台连接时被移除。在5年的随访检查中，有3枚植入物在功能中丢失，另外8枚植入物无法解释。 5年的总失败率分别为5.9％（受试者水平），5.3％（FPD水平）和2.7％（植入物水平）。在5年的观察期内，未在任何植入物中发现骨整合丧失的放射学迹象。在运行的第一年，受试者和FPD水平的种植体周围边缘骨平均损失0.33（SD，0.61）mm，而种植体水平平均损失0.31（0.81）mm。在随后的4年中，植入物周围的骨水平变化很小。受试者和FPD水平的计算出的种植体周围骨水平的年度变化为-0.02（0.15），而种植体水平为-0.03（0.20）。因此，在所有三个分析水平上，五年间隔内的平均总骨水平变化总计为0.41 mm。在基线和5年之间的间隔中，机械植入物和Tioblast（R）植入物的平均损失分别为0.33和0.48 mm（p> 0.05）。结论：本随机对照临床试验包括对部分牙周炎敏感的部分牙周炎的受试者，研究表明，骨损失（i）在功能的第一年以及此后每年减少，并且（ii）在机械或人工种植的种植体之间无差异粗糙的表面设计。

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