| Objective:The patients with edentulous jaws or the patients' residual teeth unable to retain who were treated with immediate fixed implant-supported prosthese.It evaluates the clinical efficacy by comparing the marginal bone resorption in the different time after immediate restoration,implants retention rate,prostheses retention rate,plaque index and patient satisfaction.It guides the clinical work by these results.Materials and methods:We choosed 12 patients who were edentulous jaws or residual teeth unable to retain and visited the implant department of Dalian Stomatological Hospital,from November 2013 to October 2015 to successfully complete the immediate fixed implant-supported prostheses.These patients have completed permanent restoration.All 12 patients have underwent BEGO implantation system,including 5 females and 7 males.These patients' age was 49-67 years old and including 5 cases of mandibular and 7 cases of maxillary.All patients underwent preoperative evaluation and examination to develop a detailed treatment plan.A total of4-6 implants were implanted.Sixty implants were implanted,of which 44 were implanted axially and 16 implanted obliquely.All patients have completed immediate fixed implant-supported prostheses in the day of the implanting surgery.After the osseointegration of implants were stabilized,the permanent restoration uesd CAD /CAM(Computer Aided Design/Computer Aided Manufacturing)cutting titanium bracket and polymer ceramic and fixed with screws.We measured the height of the bone in the implant margin,calculated the marginal bone resorption and analyzed statistically in the day of immediate restoration,6 months,12 months,24 months by digital panoramic radiograph.Simultaneously,Statistical data about implants retentionrate,implant complications,prostheses retention rate,complications of prosthesis,the distribution of plaque on the fitting surface of permanent prosthesis and patient satisfaction were recorded.Results:(1)During the follow-up period,sixty implants have no shedding and its function is good.The implant retention rate is 100%.There is no complication of implants.A total of 12 temporary prostheses,including 2 temporary prostheses which were fractured and repaired,retention rate is 100%.A total of 12 permanent prostheses the retention rate is 100%.There was 1 permanent prosthesis which appeared porcelain fracture and repaired.Other prostheses have no complications.Oral mucosa does not appear erythema or hyperplasia.(2)In the 6,12 and 24 months after implantation,the difference of the marginal bone resorption at the same time is not statistically significant between the axial and oblique implants(P> 0.05).The marginal bone resorption of the axial and oblique implants were respectively measured at 6,12,and 24 months after implantation.There shows statistically significant(P <0.05).(3)Six months after permanent restoration,there was a plaque indicator disclosing plaque accumulation at the fitting surfaces of the permanent prosthesis.The fitting surfaces of the permanent prosthesis was divided into the buccal(labial)area and the palatal(lingual)area according to the axial center of the implant.The average percentage of area covered with plaque was(48.10 ± 7.27)% of the total area of the fitting surface of the prostheses.The fitting surfaces of the prostheses on the buccal(labial)and palatal(lingual)area was(42.94 ± 3.10)% and(52.74 ± 3.12)%,respectively.The fitting surfaces of the prostheses on palatal(lingual)area is higher than that on the buccal(labial).There shows statistically significant between the buccal(labial)area and the palatal(lingual)area(P <0.001).The fitting surfaces of the permanent prosthesis was divided into anterior part,middle part and free-end area.The area of plaque on the anterior part was(48.77 ± 2.02)%,the middle part was(49.88 ± 1.01)%,and(72.01 ± 2.03)% in the free-end.The area of plaque on the free-end is higher than the anterior and the middle part.There is a statistically significant difference in plaque distribution area between the free-end and the other two areas(P <0.001).There is no a statistically significantdifference in plaque distribution area between the anterior part and middle part(P=0.103> 0.05).(4)According to the way of questionnaire,the quality of life related to oral health of patients was statistically analyzed.The patients are more satisfied with their fixed implant-supported prostheses.Conclusion:The patients with edentulous jaws or the patients' residual teeth unable to retain who were treated with immediate fixed implant-supported prosthese has well clinical effect,patients satisfaction is high,so it is a feasible clinical application method.In this study,the sample size is less and the clinical observation period is short.It's long-term evaluation needs to increase the sample size and extend the follow-up observation period. |
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