The Objective Clinical Efficacy Evaluation Of Edentulous Implant Fixed Restoration

Objective: This clinical study mainly analyzed the implant survival rate,prostheses success rate,and marginal bone loss,observed the complications of implants and prostheses.Through the digital occlusion analysis system and electromyography to guide to adjust occlusion,and observe the masticatory muscle function recovery,so as to objectively evaluate the long-term clinical effect of edentulous implants fixed restoration.Materials and methods: Ten patients with edentulous jaws or potentially edentulous patients were enrolled,requiring implant rehabilitation in Implant Center of Dalian Stomatological Hospital since June 2014 to December 2016.Before surgery,performed generally specialist examinations and CBCT examinations,established a plan of implant rehabilitation,fully communicated with the patients,and then operated the surgery by the Nobel system implant.After surgery explained the detailed doctor's orders,regularly review,health maintenance.When osseointegration of implants were stablized,choosed the CAD/CAM titanium stentand polymerization Ceramic porcelain permanent restoration.Adjusted the clinical occlusion to guide by the TeeTester occlusion analysis system objectively,and checked the recovery of patients' masticatory muscle through EMG.Observed 12-43 months,statisticsed implant survival and prostheses success rate.Measured the marginal bone loss at 3,6,12,24 and 36 months after surgery.observed the complications of the implants and prostheses.By statistical analysis of marginal bone loss values,compared whether there is a difference of the marginal bone loss that between the axial implant and the tilted implant,and evaluated the long-term clinical effect of the permanent restoration of the edentulous jaw.Results: Ten patients with edentulous jaws implant-fixed restoration a total of 63 implants and 24 prostheses and follow up for 12-43 months.One patient had a fracture of one implant,three patients had screw fracture,one patient had implant neck thread exposure,and three patients had porcelain with permanent prostheses.The implant survival rate was 98.4% and the prostheses success rate was 100%.Imaging examination shows: the osseointegration of 62 implants were stablized and repairing abutment completely in place.The mean marginal bone loss was 0.31 ± 0.31 mm,0.43 ± 0.53 mm,0.53 ± 0.49 mm,0.58 ± 0.51 mm,0.70 ± 0.51 mm at 3,6,12,24,36 months postoperatively.Compared with the same type of implants,there was significant difference in marginal bone loss at different time(P<0.05).At the same time,There was no significant difference in marginal bone loss between the axial implant and the tilted implant(P>0.05).After adjusted occlusion by TeeTester occlusion analysis system guided objectively,the central position of bite force recovered to the midline,the left and right lateral bite force was basically balanced.At the same time,myoelectricity tests showed that the tension of the masticatory muscle in the resting potentials was decreased,in the chewing position was enhanced after the permanent restoration.After adjusting occlusion,the coordination between the masticatory muscles recovered well.Conclusion: Patients with edentulous implant fixed restoration can achieve a higher success rate,lower marginal bone loss and long-term stable clinical effect through that repair rigorous preoperative examination,rational design,standardized clinical operation,postoperative maintenance,accurate adjustment by the TeeTester occlusion analysis system,detection of Masticatory muscle function recovery by EMG,early detection and treatment of the complications.