Extra-short (4-mm) implants placed after regenerative failures in the posterior atrophic mandible: A retrospective study.

Carlo Barausse, Andrea Ravidà, Lorenzo Bonifazi, Roberto Pistilli, Muhammad H A Saleh, Roberta Gasparro, Gilberto Sammartino, Hom-Lay Wang, Pietro Felice
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Abstract

Purpose: To explore whether extra-short (4-mm) implants could be used to rehabilitate sites where regenerative procedures had failed in order to avoid additional bone grafting.

Materials and methods: A retrospective study was conducted among patients who had received extra-short implants after failed regenerative procedures in the posterior atrophic mandible. The research outcomes were complications, implant failure and peri-implant marginal bone loss.

Results: The study population was composed of 35 patients with 103 extra-short implants placed after the failure of different reconstructive approaches. The mean follow-up duration was 41.3 ± 21.4 months post-loading. Two implants failed, leading to a failure rate of 1.94% (95% confidence interval 0.24%-6.84%) and an implant survival rate of 98.06%. The mean amount of marginal bone loss at 5 years post-loading was 0.32 ± 0.32 mm. It was significantly lower in extra-short implants placed in regenerative sites that had previously received a loaded long implant (P = 0.004). Failure of guided bone regeneration before placement of short implants tended to lead to the highest annual rate of marginal bone loss (P = 0.089). The overall rate of biological and prosthetic complications was 6.79% (95% confidence interval 1.94%-11.70%) and 3.88% (95% confidence interval 1.07%-9.65%), respectively. The success rate was 86.4% (95% confidence interval 65.10%-97.10%) after 5 years of loading.

Conclusions: Within the limitations of this study, extra-short implants seem to be a good clinical option to manage reconstructive surgical failures, reducing surgical invasiveness and rehabilitation time.

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后萎缩下颌骨再生失败后放置超短(4毫米)种植体:一项回顾性研究。
目的:探讨超短(4毫米)种植体是否可以用于修复再生手术失败的部位,以避免额外的植骨。材料和方法:对后侧萎缩下颌骨再生手术失败后接受超短种植体的患者进行回顾性研究。研究结果为并发症、种植体失败和种植体周围边缘骨丢失。结果:研究人群由35例患者组成,在不同的重建入路失败后放置103个超短种植体。平均随访时间为41.3±21.4个月。2例种植体失败,失败率为1.94%(95%可信区间0.24% ~ 6.84%),种植体成活率为98.06%。加载后5年的平均边缘骨丢失量为0.32±0.32 mm。在再生部位放置超短种植体,而之前接受了加载的长种植体,则显著降低(P = 0.004)。在植入短种植体之前引导骨再生失败往往导致最高的年边际骨损失率(P = 0.089)。生物并发症和假体并发症的总发生率分别为6.79%(95%可信区间1.94% ~ 11.70%)和3.88%(95%可信区间1.07% ~ 9.65%)。加载5年后,成功率为86.4%(95%置信区间65.10% ~ 97.10%)。结论:在本研究的限制下,超短种植体似乎是一种很好的临床选择,可以处理重建手术失败,减少手术侵入性和康复时间。
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