短种植体在上颌后牙区的应用与风险

doi:10.12337/zgkqzzxzz.2021.08.002

摘要/Abstract

摘要： 上颌后牙区种植常面临可用骨高度不足的问题,使用短种植体可以避免骨增量手术,得到良好的临床效果,但也有一些因素会给短种植体的成功应用带来风险。本文介绍了短种植体的定义与发展,对短种植体应用于上颌后牙区的风险因素进行探讨,并对种植体与修复方式的选择提出建议。

关键词: 短种植体, 上颌后牙区, 风险因素, 修复设计

Abstract: In the posterior maxilla, dental implant placement is usually challenged by insufficient ridge height. Short implants could be used as an alternative to bone augmentation procedures and obtain good clinical outcomes. However, some factors may bring risks to the successful application of short implants. This review introduces the definition and development of short implants, discusses risk factors of short implants in the posterior maxilla, and provides recommendations for the choice of implant size and restoration design when using short implants.

Key words: Short implants, Posterior maxilla, Risk factors, Restoration design

施斌,等廖一林,等晏奇. 短种植体在上颌后牙区的应用与风险[J]. 中国口腔种植学杂志, 2021, 26(4): 213-218. DOI: 10.12337/zgkqzzxzz.2021.08.002

Shi Bin, Liao Yilin, Yan Qi. Application and risk of short implants in maxillary posterior teeth[J].Chinese Journal of Oral Implantology, 2021, 26(4): 213-218.DOI: 10.12337/zgkqzzxzz.2021.08.002.

参考文献

[1] Kopecka D, Simunek A, Brazda T, et al.Relationship between subsinus bone height and bone volume requirements for dental implants: a human radiographic study[J]. Int J Oral Maxillofac Implants, 2012,27(1):48-54.
[2] Felice P, Barausse C, Pistilli R, et al.Short implants versus longer implants in vertically augmented posterior mandibles: result at 8 years after loading from a randomised controlled trial[J]. Eur J Oral Implantol, 2018,11(4):385-395.
[3] Lombardo G, Signoriello A, Simancas-Pallares M, et al.Survival of short and ultra-short locking-taper implants supporting single crowns in the posterior mandible: a 3-year retrospective study[J]. J Oral Implantol, 2020,46(4):396-406. DOI: 10.1563/aaid-joi-D-19-00190.
[4] Vetromilla BM, Mazzetti T, Pereira-Cenci T.Short versus standard implants associated with sinus floor elevation: an umbrella review of meta-analyses of multiple outcomes[J]. J Prosthet Dent, 2020,DOI: 10.1016/j.prosdent.2020.08.002.
[5] Carosi P, Lorenzi C, Laureti M, et al.Short dental implants (≤6 mm) to rehabilitate severe mandibular atrophy: a systematic review[J]. Int J Oral Maxillofac Implants, 2021,36(1):30-37. DOI: 10.11607/jomi.8510.
[6] Yan Q, Wu X, Su M, et al.Short implants (≤6 mm) versus longer implants with sinus floor elevation in atrophic posterior maxilla: a systematic review and meta-analysis[J]. BMJ Open, 2019,9(10):e029826. DOI: 10.1136/bmjopen-2019-029826.
[7] Fan T, Li Y, Deng WW, et al.Short implants (5 to 8 mm) versus longer implants (>8 mm) with sinus lifting in atrophic posterior maxilla: a meta-analysis of RCTs[J]. Clin Implant Dent Relat Res, 2017,19(1):207-215. DOI: 10.1111/cid.12432.
[8] Ravidà A, Barootchi S, Askar H, et al.Long-Term effectiveness of extra-short (≤6 mm) dental implants: a systematic review[J]. Int J Oral Maxillofac Implants, 2019,34(1):68-84. DOI: 10.11607/jomi.6893.
[9] Papaspyridakos P, De Souza A, Vazouras K, et al. Survival rates of short dental implants (≤6 mm) compared with implants longer than 6 mm in posterior jaw areas: a meta-analysis[J]. Clin Oral Implants Res, 2018,29 Suppl 16:8-20. DOI: 10.1111/clr.13289.
[10] Sun HL, Huang C, Wu YR, et al.Failure rates of short (≤10 mm) dental implants and factors influencing their failure: a systematic review[J]. Int J Oral Maxillofac Implants, 2011,26(4):816-825.
[11] Feldman S, Boitel N, Weng D, et al.Five-year survival distributions of short-length (10 mm or less) machined-surfaced and osseotite implants[J]. Clin Implant Dent Relat Res, 2004,6(1):16-23. DOI: 10.1111/j.1708-8208.2004.tb00023.x.
[12] Thoma DS, Zeltner M, Hüsler J, et al. EAO supplement working group 4 - EAO CC2015 short implants versus sinus lifting with longer implants to restore the posterior maxilla: a systematic review[J]. Clin Oral Implants Res, 2015,26 Suppl 11:154-169. DOI: 10.1111/clr.12615.
[13] Hämmerle C, Cordaro L, Alccayhuaman K, et al. Biomechanical aspects: summary and consensus statements of group 4. The 5(th) EAO consensus conference2018[J]. Clin Oral Implants Res, 2018,29 Suppl 18:326-331. DOI: 10.1111/clr.13284.
[14] Jung RE, Al-Nawas B, Araujo M, et al. Group 1 ITI Consensus Report: the influence of implant length and design and medications on clinical and patient-reported outcomes[J]. Clin Oral Implants Res, 2018,29 Suppl 16:69-77. DOI: 10.1111/clr.13342.
[15] Markose J, Eshwar S, Srinivas S, et al.Clinical outcomes of ultrashort sloping shoulder implant design: a survival analysis[J]. Clin Implant Dent Relat Res, 2018,20(4):646-652. DOI: 10.1111/cid.12608.
[16] Shah SN, Chung J, Kim DM, et al.Can extra-short dental implants serve as alternatives to bone augmentation? a preliminary longitudinal randomized controlled clinical trial[J]. Quintessence Int, 2018,49(8):635-643. DOI: 10.3290/j.qi.a40763.
[17] ten Bruggenkate CM, Asikainen P, Foitzik C, et al. Short (6-mm) nonsubmerged dental implants: results of a Multicenter clinical trial of 1 to 7 years[J]. Int J Oral Maxillofac Implants, 1998,13(6):791-798.
[18] Lai HC, Si MS, Zhuang LF, et al.Long-term outcomes of short dental implants supporting single crowns in posterior region: a clinical retrospective study of 5-10 years[J]. Clin Oral Implants Res, 2013,24(2):230-237. DOI: 10.1111/j.1600-0501.2012.02452.x.
[19] Esposito M, Ardebili Y, Worthington HV. WITHDRAWN: Interventions for replacing missing teeth: different types of dental implants[J]. Cochrane Database Syst Rev, 2019,10(10):CD003815. DOI: 10.1002/14651858.CD003815.pub5.
[20] Srinivasan M, Vazquez L, Rieder P, et al.Survival rates of short (6 mm) micro-rough surface implants: a review of literature and meta-analysis[J]. Clin Oral Implants Res, 2014,25(5):539-545. DOI: 10.1111/clr.12125.
[21] Nisand D, Renouard F.Short implant in limited bone volume[J]. Periodontol 2000, 2014,66(1):72-96. DOI: 10.1111/prd.12053.
[22] Schwartz SR.Short implants: are they a viable option in implant dentistry?[J]. Dent Clin North Am, 2015,59(2):317-328. DOI: 10.1016/j.cden.2014.10.008.
[23] Lee EY, Kim ES, Kim KW.Vertical augmentation of maxillary posterior alveolar ridge using allogenic block bone graft and simultaneous maxillary sinus graft[J]. Maxillofac Plast Reconstr Surg, 2014,36(5):224-229. DOI: 10.14402/jkamprs.2014.36.5.224.
[24] Hong SJ, Yang BE, Yoo DM, et al.Analysis of the relationship between periodontitis and osteoporosis/fractures: a cross-sectional study[J]. BMC Oral Health, 2021,21(1):125. DOI: 10.1186/s12903-021-01496-1.
[25] Lombardo G, Signoriello A, Marincola M, et al.Assessment of peri-implant soft tissues conditions around short and ultra-short implant-supported single crowns: a 3-year retrospective study on periodontally healthy patients and patients with a history of periodontal disease[J]. Int J Environ Res Public Health, 2020,17(24).DOI: 10.3390/ijerph17249354.
[26] Hasanoglu Erbasar GN, Hocaoğlu TP, Erbasar RC.Risk factors associated with short dental implant success: a long-term retrospective evaluation of patients followed up for up to 9 years[J]. Braz Oral Res, 2019,33:e030. DOI: 10.1590/1807-3107bor-2019.vol33.0030.
[27] Smith MM, Knight ET, Al-Harthi L, et al.Chronic periodontitis and implant dentistry[J]. Periodontol 2000, 2017,74(1):63-73. DOI: 10.1111/prd.12190.
[28] Roccuzzo M, Bonino L, Dalmasso P, et al.Long-term results of a three arms prospective cohort study on implants in periodontally compromised patients: 10-year data around sandblasted and acid-etched (SLA) surface[J]. Clin Oral Implants Res, 2014,25(10):1105-1112. DOI: 10.1111/clr.12227.
[29] Yan X, Lu H, Zhang L, et al.A three-year study on periodontal microorganisms of short locking-taper implants and adjacent teeth in patients with history of periodontitis[J]. J Dent, 2020,95:103299. DOI: 10.1016/j.jdent.2020.103299.
[30] Chrcanovic BR, Albrektsson T, Wennerberg A.Smoking and dental implants: a systematic review and meta-analysis[J]. J Dent, 2015,43(5):487-498. DOI: 10.1016/j.jdent.2015.03.003.
[31] Chambrone L, Preshaw PM, Ferreira JD, et al.Effects of tobacco smoking on the survival rate of dental implants placed in areas of maxillary sinus floor augmentation: a systematic review[J]. Clin Oral Implants Res, 2014,25(4):408-416. DOI: 10.1111/clr.12186.
[32] Al Amri MD, Abduljabbar TS, Al-Johany SS, et al.Comparison of clinical and radiographic parameters around short (6 to 8 mm in length) and long (11 mm in length) dental implants placed in patients with and without type 2 diabetes mellitus: 3-year follow-up results[J]. Clin Oral Implants Res, 2017,28(10):1182-1187. DOI: 10.1111/clr.12938.
[33] Mokeem S, Alfadda SA, Al-Shibani N, et al.Clinical and radiographic peri-implant variables around short dental implants in type 2 diabetic, prediabetic, and non-diabetic patients[J]. Clin Implant Dent Relat Res, 2019,21(1):60-65. DOI: 10.1111/cid.12691.
[34] Jagadeesh KN, Verma AK, Parihar AS, et al.Assessment of the survival rate of short dental Implants in medically compromised patients[J]. J Contemp Dent Pract, 2020,21(8):880-883.
[35] Nguyen T, Eo MY, Cho YJ, et al.7-mm-long dental implants: retrospective clinical outcomes in medically compromised patients[J]. J Korean Assoc Oral Maxillofac Surg, 2019,45(5):260-266. DOI: 10.5125/jkaoms.2019.45.5.260.
[36] Tang Y, Yu H, Wang J, et al.Influence of crown-to-implant ratio and different prosthetic designs on the clinical conditions of short implants in posterior regions: a 4-year retrospective clinical and radiographic study[J]. Clin Implant Dent Relat Res, 2020,22(1):119-127. DOI: 10.1111/cid.12881.
[37] Chen L, Yang T, Yang G, et al.Retrospective clinical analysis of risk factors associated with failed short implants[J]. Clin Implant Dent Relat Res, 2020,22(1):112-118. DOI: 10.1111/cid.12879.
[38] Lin G, Ye S, Liu F, et al.A retrospective study of 30,959 implants: risk factors associated with early and late implant loss[J]. J Clin Periodontol, 2018,45(6):733-743. DOI: 10.1111/jcpe.12898.
[39] Ravidà A, Majzoub J, Alassadi M, et al.Impact of implant length on survival of rough-surface implants in nonaugmented posterior areas: a systematic review and meta-regression analysis[J]. Int J Oral Maxillofac Implants, 2019,34(6):1359-1369. DOI: 10.11607/jomi.7509.
[40] Cheng Y, Mei S, Kong X, et al.Long-term antibacterial activity of a composite coating on titanium for dental implant application[J]. J Biomater Appl, 2021,35(6):643-654. DOI: 10.1177/0885328220963934.
[41] Villarinho EA, Triches DF, Alonso FR, et al.Risk factors for single crowns supported by short (6-mm) implants in the posterior region: a prospective clinical and radiographic study[J]. Clin Implant Dent Relat Res, 2017,19(4):671-680. DOI: 10.1111/cid.12494.
[42] Shi JY, Lai YR, Qian SJ, et al.Clinical, radiographic and economic evaluation of short-6-mm implants and longer implants combined with osteotome sinus floor elevation in moderately atrophic maxillae: a 3-year randomized clinical trial[J]. J Clin Periodontol, 2021,48(5):695-704. DOI: 10.1111/jcpe.13444.
[43] Eazhil R, Swaminathan SV, Gunaseelan M, et al.Impact of implant diameter and length on stress distribution in osseointegrated implants: a 3D FEA study[J]. J Int Soc Prev Community Dent, 2016,6(6):590-596. DOI: 10.4103/2231-0762.195518.
[44] Raaj G, Manimaran P, Kumar CD, et al.Comparative evaluation of implant designs: influence of diameter, length, and taper on stress and strain in the mandibular segment-a three-dimensional finite element analysis[J]. J Pharm Bioallied Sci, 2019,11(Suppl 2):S347-347S354. DOI: 10.4103/JPBS.JPBS_29_19.
[45] Chang SH, Lin CL, Hsue SS, et al.Biomechanical analysis of the effects of implant diameter and bone quality in short implants placed in the atrophic posterior maxilla[J]. Med Eng Phys, 2012,34(2):153-160. DOI: 10.1016/j.medengphy.2011.07.005.
[46] de Souza Batista VE, Verri FR, Lemos C, et al. Should the restoration of adjacent implants be splinted or nonsplinted? a systematic review and meta-analysis[J]. J Prosthet Dent, 2019,121(1):41-51. DOI: 10.1016/j.prosdent.2018.03.004.
[47] Mendonça JA, Francischone CE, Senna PM, et al.A retrospective evaluation of the survival rates of splinted and non-splinted short dental implants in posterior partially edentulous jaws[J]. J Periodontol, 2014,85(6):787-794. DOI: 10.1902/jop.2013.130193.
[48] de Souza Batista VE, Verri FR, Lemos C, et al. Should the restoration of adjacent implants be splinted or nonsplinted? a systematic review and meta-analysis[J]. J Prosthet Dent, 2019,121(1):41-51. DOI: 10.1016/j.prosdent.2018.03.004.
[49] Esfahrood ZR, Ahmadi L, Karami E, et al.Short dental implants in the posterior maxilla: a review of the literature[J]. J Korean Assoc Oral Maxillofac Surg, 2017,43(2):70-76. DOI: 10.5125/jkaoms.2017.43.2.70.
[50] Ravidà A, Barootchi S, Alkanderi A, et al.The effect of crown-to-implant ratio on the clinical outcomes of dental implants: a systematic review[J]. Int J Oral Maxillofac Implants, 2019,34(5):1121-1131. DOI: 10.11607/jomi.7355.
[51] Al-Johany SS.Survival rates of short dental implants (≤ 6.5 mm) placed in posterior edentulous ridges and factors affecting their survival after a 12-month follow-up period: a systematic review[J]. Int J Oral Maxillofac Implants, 2019,34(3):605-621. DOI: 10.11607/jomi.7187.
[52] Di Fiore A, Vigolo P, Sivolella S, et al.Influence of crown-to-implant ratio on long-term marginal bone loss around short implants[J]. Int J Oral Maxillofac Implants, 2019,34(4):992-998. DOI: 10.11607/jomi.7161.
[53] Gonçalves TM, Bortolini S, Martinolli M, et al.Long-term short implants performance: systematic review and meta-analysis of the essential assessment parameters[J]. Braz Dent J, 2015,26(4):325-336. DOI: 10.1590/0103-6440201300265.
[54] Nissan J, Ghelfan O, Gross O, et al.The effect of crown/implant ratio and crown height space on stress distribution in unsplinted implant supporting restorations[J]. J Oral Maxillofac Surg, 2011,69(7):1934-1939. DOI: 10.1016/j.joms.2011.01.036.