Rok Gašperšič^1,*; Michel Dard^2,3; Susy Linder³; Čedomir Oblak⁴

¹Department of Oral Medicine and Periodontology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; ²College of Dental Medicine, Columbia University, New York, United States; ³Institut Straumann AG, Basel, Switzerland; ⁴Department of Prosthodontics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

Background: Extra-short 4-mm implants splinted to 10-mm implants may present an alternative solution for rehabilitation of patients having a shortened maxillary dental arch and expanded maxillary sinus when extensive bone grafting is not possible. Favorable radiographic marginal bone level and survival rates of the 4-mm implants splinted to 10-mm implants after 1 year were already described (IJOMI, 36(2):371-378). However, follow-up data are needed to support the feasibility of such a treatment option.

Aim/Hypothesis: To evaluate the two-year survival and success rates of oral rehabilitations in a shortened maxillary dental arch and expanded maxillary sinus with 4-mm extra-short implants splinted to 10-mm ones, placed during the same surgical procedure.

Material and Methods: Eleven (n = 11) patients with a shortened dental arch and expanded maxillary sinus antrum were selected. The sample included smokers (n = 3) and patients with history of chronic periodontitis (n = 6). One 10-mm and one/two extra-short 4-mm titanium-zirconium SLActive tissue-level dental implants (Institute Straumann, Basel, Switzerland) were inserted in the posterior maxilla with sufficiently wide alveolar ridge. Splinted crowns combining 4- and 10-mm implants were supplied to all 11 cases 6 months after insertion when optimal stability was confirmed by the resonance-frequency analysis (Osstell^©, Integration Diagnostics, Goteborg, Sweden). All the patients were restored with metal-ceramic fixed dental prostheses. The metal frameworks were computer designed and milled from a cobalt-chromium alloy Coron^© (Institute Straumann, Basel, Switzerland). During the first year, all patients were examined and maintained every 4 months, and in the second year, every 6 months.

Results: After 2 years, all (11/11) oral rehabilitations supported by 10-mm (11/11) and 4-mm (16/16) implants were functional and demonstrated a 100% post-loading survival rate. All (16/16) 4-mm implants and 10 of 11 10-mm implants showed stable soft tissue level and marginal bone. Besides bleeding of probing sites at 3/11 of 10-mm implants and 3/16 of 4-mm implants, no signs of peri-implant pathology were detected. Due to tissue recession close to the extraction of a neighbouring non-tested implant, the 2-year post-loading success rate was reduced to 91% for the 10-mm implants.

Conclusion and Clinical implications: Rehabilitations with splinted crowns combining 4- and 10-mm implants demonstrated a favorable 2-year performance in a shortened maxillary dental arch. However, further follow-ups and long-term comparative studies are still required to support this treatment solution for a partially edentulous posterior maxilla.

Disclosure of Interest: None Declared

Keywords: clinical studies/trials, implant-supported restorations, short implants

Rok Gašperšič ^1,* ; 米歇尔·达德^2,3 ; 苏西林德³ ; Čedomir Oblak ⁴

¹斯洛文尼亚卢布尔雅那卢布尔雅那大学医学院口腔医学和牙周病学系；²美国纽约哥伦比亚大学牙医学院；³ Institut Straumann AG，瑞士巴塞尔；⁴卢布尔雅那大学医学院修复学系，卢布尔雅那，斯洛文尼亚

背景：当无法进行广泛的骨移植时，超短 4 毫米种植体与 10 毫米种植体的夹板可能为上颌牙弓缩短和上颌窦扩张患者的康复提供替代解决方案。已经描述了 1 年后从 4 毫米植入物夹板到 10 毫米植入物的有利放射学边缘骨水平和存活率 (IJOMI, 36(2):371-378)。然而，需要后续数据来支持这种治疗方案的可行性。

目的/假设：评估缩短的上颌牙弓和扩张的上颌窦的口腔康复的两年生存率和成功率，其中 4 毫米超短种植体夹板固定到 10 毫米种植体，在同一手术过程中放置​​。

材料和方法：选择了11 名（n = 11）牙弓缩短和上颌窦扩大的患者。样本包括吸烟者 ( n = 3) 和有慢性牙周炎病史的患者 ( n = 6)。将一颗 10 毫米和一/两颗超短 4 毫米钛锆 SLActive 组织级牙种植体（瑞士巴塞尔斯特劳曼研究所）插入具有足够宽牙槽嵴的后上颌骨。插入 6 个月后，当共振频率分析确认最佳稳定性时，向所有 11 个病例提供了结合 4 毫米和 10 毫米种植体的夹板牙冠 (Osstell ^©，Integration Diagnostics，瑞典哥德堡）。所有患者均采用金属陶瓷固定义齿修复。金属框架由计算机设计并由钴铬合金 Coron ^©（Straumann 研究所，瑞士巴塞尔）铣削而成。第一年，所有患者每4个月检查和维护一次，第二年每6个月检查一次。

结果： 2年后，所有（11/11）口服平反支持10毫米（11/11）和4毫米（16/16）种植体功能和展示了后负荷的存活率为100％。所有 (16/16) 4 毫米种植体和 11 个 10 毫米种植体中的 10 个都显示出稳定的软组织水平和边缘骨。除了 3/11 的 10 毫米种植体和 3/16 的 4 毫米种植体的探测部位出血外，没有检测到种植体周围病变的迹象。由于邻近未测试种植体的提取附近的组织衰退，10 毫米种植体的 2 年加载后成功率降低至 91%。

结论和临床意义：夹板牙冠结合 4 毫米和 10 毫米种植体的修复在缩短的上颌牙弓中表现出良好的 2 年性能。然而，仍需要进一步的随访和长期的比较研究来支持这种治疗部分缺牙的上颌后牙的解决方案。

利益披露：无申报

关键词：临床研究/试验，种植体支持修复体，短种植体