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植牙全過程：從評估到裝上牙冠，會經歷哪幾關？｜證據鏈

km 編輯部2026-08-13閱讀約 54 分鐘
#證據鏈#牙醫KM#台灣#植牙

本頁是〈植牙全過程：從評估到裝上牙冠，會經歷哪幾關？〉的事實單元帳：每一條主張對應的來源、證據等級、地域與期間、原文引句與限制，逐條攤開。

植牙全過程：從評估到裝上牙冠，會經歷哪幾關？｜證據鏈

F-Units（事實單元帳）

每條標明 confidence／basis／period／geo／逐字 span／caveat。basis 階梯：law ＞ official_statement ＞ clinical_guideline ＞ peer_reviewed ＞ textbook；撤回文獻標 withdrawn_publication／not_evidence，不作臨床證據。

  • F1｜confidence: high｜basis: internal_dataset（非醫學 basis）｜period: GSC 保留窗（2025-03 起）｜geo: TW｜來源 S27｜本題查詢族共 6 個詞項、跨 5 個站，逐筆可對帳；選題證據數值保留於草稿 frontmatter 與內部檔案，發布轉檔時不進可見層（2026-08-05 裁定）。
  • F2｜無外部來源｜basis: editorial_framework（結構性整理，非事實宣稱，不得標為待驗）｜period: 2026-08-06｜geo: universal｜來源 S28｜「九關」時間軸、checklist 八題與「這張卡管什麼」的分工聲明，均為本站依 F3 至 F28 文獻與法規整理的溝通用結構，不是官方分類，也不是臨床指引。
  • F3｜confidence: verified（2026-08-06 以 ego-browser 實測可達，條文逐字對得上）｜basis: law（醫療法第 63 條）｜period: 現行條文｜geo: TW｜來源 S22｜span:「醫療機構實施手術，應向病人或其法定代理人、配偶、親屬或關係人說明手術原因、手術成功率或可能發生之併發症及危險，並經其同意，簽具手術同意書及麻醉同意書，始得為之。但情況緊急者，不在此限。」｜caveat: 條文引述，非個案法律意見；同 KM-DENTAL-09 錨。
  • F4｜confidence: verified（2026-08-06 實測，逐字對得上）｜basis: law（醫療法第 81 條）｜period: 現行條文｜geo: TW｜來源 S23｜span:「醫療機構診治病人時，應向病人或其法定代理人、配偶、親屬或關係人告知其病情、治療方針、處置、用藥、預後情形及可能之不良反應。」｜caveat: 條文引述，本卡據此說明「用藥屬醫師處方判斷、應由醫師說明」，不提供任何用藥建議。
  • F5｜confidence: verified（2026-08-06 實測，逐字對得上）｜basis: law（醫療法第 87 條第 2 項）｜period: 現行條文｜geo: TW｜來源 S24｜span:「醫學新知或研究報告之發表、病人衛生教育、學術性刊物，未涉及招徠醫療業務者，不視為醫療廣告。」｜caveat: 本卡合規定位依據。
  • F6｜confidence: verified（2026-08-06 實測，逐字對得上）｜basis: law（醫療法第 21 條）｜period: 現行條文｜geo: TW｜來源 S25｜span:「醫療機構收取醫療費用之標準，由直轄市、縣（市）主管機關核定之。」｜caveat: 條文本身不含任何金額；本卡僅以一句帶過並導向 KM-DENTAL-09。
  • F7｜confidence: verified（2026-08-06 實測，第 11 款逐字對得上）｜basis: law（全民健康保險法第 51 條第 11 款）｜period: 現行條文｜geo: TW｜來源 S26｜span:「義齒、義眼、眼鏡、助聽器、輪椅、拐杖及其他非具積極治療性之裝具。」｜caveat: 條文列舉的是不給付項目；療程中其他處置之給付與否以健保署現行公告為準。
  • F8｜confidence: verified｜basis: peer_reviewed（systematic review，PMID 24660190）｜period: 檢索至 2012-10-31，2014 刊出；檢索日 2026-08-06｜geo: universal｜來源 S1｜span:「The reported indications for CBCT use in implant dentistry vary from preoperative analysis regarding specific anatomic considerations, site development using grafts, and computer-assisted treatment planning to postoperative evaluation focusing on complications due to damage of neurovascular structures.」「Effective doses for different CBCT devices exhibit a wide range with the lowest dose being almost 100 times less than the highest dose.」「Significant dose reduction can be achieved by adjusting operating parameters, including exposure factors and reducing the field of view (FOV) to the actual region of interest.」｜caveat: 檢索窗較舊，機型與劑量已有變動；本卡僅用於說明影像屬獨立評估項目與劑量可調整，不作機型比較。同 KM-DENTAL-09 錨。
  • F9｜confidence: verified｜basis: peer_reviewed（AO/AAP systematic review・meta-analysis，PMID 40489307，102 篇研究、13,030 位病人）｜period: 2025 刊出｜geo: universal｜來源 S2｜span:「Prevalence rates at the patient level for peri-implant mucositis and peri-implantitis were 46% (95% confidence interval [CI], 41-51) and 21% (95% CI, 17-24), respectively.」「For peri-implantitis, the significant risk indicators were periodontitis, diabetes mellitus, smoking habits, and alcohol consumption.」「Pooled estimates identified periodontitis, obesity, and smoking habits as significant systemic risk indicators for mucositis.」「Only risk indicators could be identified in the selected evidence.」｜caveat: 風險指標為關聯性、非因果；盛行率為族群層級數字，非個人機率。同 KM-DENTAL-20 錨。
  • F10｜confidence: verified｜basis: peer_reviewed（systematic review，PMID 19885446，91 篇納入）｜period: 2009 刊出；檢索日 2026-08-06，本卡另引 2018 與 2026 年同主題回顧（F16）互相校正，本條僅用於植入時機的分型與軟組織結果｜geo: universal｜來源 S3｜span:「Bone augmentation procedures are effective in promoting bone fill and defect resolution at implants in postextraction sites, and are more successful with immediate (type 1) and early placement (type 2 and type 3) than with late placement (type 4).」「The majority of studies reported survival rates of over 95%.」「Recession of the facial mucosal margin is common with immediate (type 1) placement.」「Early implant placement (type 2 and type 3) is associated with a lower frequency of mucosal recession compared to immediate placement (type 1).」｜caveat: 2009 年回顧、納入研究平均追蹤至少 12 個月；存活率為研究層級估計，非個人預後承諾；本卡不引用任何以週數表示的分型時間窗，因該摘要未載。
  • F11｜confidence: verified｜basis: peer_reviewed（Cochrane systematic review，PMID 33899930，CD010176.pub3）｜period: 檢索至 2021-03-19，2021 刊出；為 2015 年初版之更新版，檢索日 2026-08-06 未見更新的 pub4｜geo: universal｜來源 S4｜span:「We included 16 RCTs conducted worldwide involving a total of 524 extraction sites in 426 adult participants.」「ARP techniques may minimise the overall changes in residual ridge height and width six months after extraction but the evidence is very uncertain.」「There is lack of evidence of any differences in the need for additional augmentation at the time of implant placement, implant failure, aesthetic outcomes, or any other clinical parameters due to lack of information or long-term data.」｜caveat: 證據確定性很低；不得改寫為「補骨可以避免日後再補骨」。同 KM-DENTAL-09 錨。
  • F12｜confidence: verified｜basis: peer_reviewed（systematic review・meta-analysis，PMID 30624791）｜period: 檢索至 2018-05，2019 刊出｜geo: universal｜來源 S5｜span:「Overall, 25 trials (16 randomized/9 non-randomized) were identified, which included a total of 553 patients (42.2% male; mean age of 43.9 years).」「In these included studies and populations, various modalities for primary lateral bone augmentation rendered implant placement feasible.」「However, the quality of evidence ranged from very low to moderate due to bias and imprecision.」｜caveat: 作者自陳證據品質很低至中等；本卡僅用於說明骨處置是獨立階段、會影響療程長度，不作療效宣稱。同 KM-DENTAL-09 錨。
  • F13｜confidence: verified｜basis: peer_reviewed（systematic review・meta-analysis，PMID 40221370）｜period: 檢索至 2024-08，2025 刊出｜geo: universal｜來源 S6｜span:「Forty-five studies met the inclusion criteria.」「However, factors such as cost-effectiveness, edentulous span, and clinician expertise must be considered, as conventional methods remain suitable alternatives in certain straightforward situations.」｜caveat: 結果指標是「置入位置與計畫的偏差」，不是臨床成功率或存活率；本卡未引用其偏差數值，僅引用其方向與作者的限定；禁改寫為「導板比較好」。同 KM-DENTAL-09 錨。
  • F14｜confidence: verified｜basis: peer_reviewed（Cochrane systematic review・meta-analysis，PMID 23543525，CD003878.pub4）｜period: 檢索至 2012-06，2013 刊出；版本鏈查證 2026-08-06：PubMed 以 CD003878 檢索得 5 筆版本（2003／2004／2007／2009／2013），2013 年版為現行最新版，MEDLINE 記錄無 UIN（無更新版）、無撤回標記，pubtype 不含 Retracted Publication｜geo: universal｜來源 S7｜span:「dental implants are kept load-free for 3 to 8 months to establish osseointegration (conventional loading)」「immediate (within 1 week), early (between 1 week and 2 months), and conventional (after 2 months) loading」「26 trials including a total of 1217 participants and 2120 implants were included」「the mean rate of implant failure in all 26 trials was a low 2.5%」「Overall there was no convincing evidence of a clinically important difference in prosthesis failure, implant failure, or bone loss associated with different loading times」｜caveat: 3 至 8 個月一句出自該回顧的 BACKGROUND 段（對傳統做法的背景描述），不是該回顧的結果或建議，也不是對任何個案的時程承諾；作者指出 12 篇為高偏差風險；追蹤期 4 個月至 1 年。同 KM-DENTAL-20 錨。
  • F15｜confidence: verified｜basis: peer_reviewed（systematic review・meta-analysis，PMID 24660200）｜period: 檢索至 2012-08，2014 刊出｜geo: universal｜來源 S8｜span:「Immediately and conventionally loaded single-implant crowns are equally successful regarding implant survival and marginal bone loss.」「This conclusion is primarily derived from studies evaluating implants inserted with a torque ≥ 20 to 45 Ncm or an implant stability quotient (ISQ) ≥ 60 to 65 and with no need for simultaneous bone augmentation.」｜caveat: 結論限定於高初期穩定度且不需同時補骨的病例，禁外推為「所有人都可以立即裝牙」；本卡不因此提供任何療程天數。同 KM-DENTAL-09、KM-DENTAL-20 錨。
  • F16｜confidence: verified｜basis: peer_reviewed（systematic review，PMID 41574557）｜period: 2026-02 刊出；時效查證 2026-08-06：本篇為同一團隊 2018 年版（PMID 30328194）的更新版，本卡改採此版並停用舊版數字；pubtype 為 Journal Article／Systematic Review，不含 Retracted Publication｜geo: universal｜來源 S9｜span:「From 11 427 records, 140 studies (42 RCTs; 98 CCTs/cohort studies) encompassing 10 456 implants met the criteria.」「Protocols 1A, 1C, 2-3C, 4A, 4B, and 4C satisfy scientific and/or clinical validation thresholds, whereas 1B and 2-3B remain insufficiently documented despite high numeric survival.」｜caveat: 加權累積存活率為研究層級估計、非個人成功率之承諾；本卡刻意不逐一列出各組合的存活率數值，以免被讀成療效宣稱；限部分缺牙病人之固定式植體假牙。
  • F17｜confidence: verified｜basis: clinical_guideline（ITI Group 5 Consensus Report，PMID 37750529，pubtype 含 Consensus Statement）｜period: 2023-09 刊出｜geo: universal｜來源 S10｜span:「the Type 1A protocol (immediate placement and immediate loading), when utilized in the anterior maxilla under favorable conditions, is considered predictable and is associated with high survival rates」「The procedure is considered clinically viable and is associated with aesthetic outcomes, although surgical, technical, and biological complications can occur.」｜caveat: 共識範圍限於上顎前牙區單顆缺牙且條件有利者，不可外推至所有位置與所有病人；共識報告為專家群依兩篇系統性回顧與經驗形成，非隨機試驗結果。
  • F18｜confidence: verified（記錄用）｜basis: withdrawn_publication／not_evidence（PMID 29791009，Cochrane Database Syst Rev. 2018;5(5):CD006698，標題含 WITHDRAWN）｜period: 2018-05-23 撤回｜geo: universal｜來源 S11｜span:「WITHDRAWN: Interventions for replacing missing teeth: 1- versus 2-stage implant placement.」｜caveat: 本條僅用於記錄一件事——一階與二階置入這個臨床問題目前無現行有效的 Cochrane 結論；該撤回文獻的內容與結論一律不得作為臨床證據引用；本卡該段改引 F19、F20 兩篇非 Cochrane 系統性回顧。
  • F19｜confidence: verified｜basis: peer_reviewed（systematic review・meta-analysis・trial sequential analysis，PMID 29574852，11 篇納入）｜period: 2018-05 刊出｜geo: universal｜來源 S12｜span:「Results of this systematic review revealed a small higher rate (2%) of early implant failure when a non-submerged healing approach is performed.」「The power of the evidence about the effects on MBL is low, but present results seem to favour non-submerged healing, although with a very small effect size.」｜caveat: 納入研究排除立即負載案例；作者自陳邊緣骨部分證據強度低。原文僅寫 a small higher rate (2%)，未指明為絕對風險差或相對風險差；本卡照原文以 2% 記述並明示此不確定性，禁改寫為百分點、禁改寫為個人風險。
  • F20｜confidence: verified｜basis: peer_reviewed（systematic review・meta-analysis，PMID 29316568，6 篇隨機試驗納入分析）｜period: 2018 刊出｜geo: universal｜來源 S13｜span:「There were no differences between the two interventions regarding implant or prosthesis failures, and (2) submerged implants exhibited statistically significantly more MBL, but this difference was not clinically relevant.」「These conclusions should be interpreted with caution, since the present review is underpowered and the included RCTs were considered to be at high risk of bias.」｜caveat: 作者自陳檢定力不足、4 篇納入試驗偏差風險高；與 F19 方向不完全一致，本卡並列呈現、不擇一宣稱。
  • F21｜confidence: verified｜basis: peer_reviewed（systematic review，PMID 27041111）｜period: 檢索至 2015-07-31，2016 刊出｜geo: universal｜來源 S14｜span:「Human studies reporting on soft tissue augmentation/correction methods around submucosally osseointegrated implants during second-stage surgery up to July 31, 2015 were considered.」「Overall, eight prospective studies (risk of bias: high) and two case series (risk of bias: high) were included.」「Due to the heterogeneity of study designs, no meta-analysis could be performed.」｜caveat: 納入研究偏差風險皆高、無法統合分析；本卡僅引用兩件事——二階手術期間可能一併處理軟組織，以及該題證據品質有限——不引用任何術式優劣結論。
  • F22｜confidence: verified｜basis: peer_reviewed（systematic review・meta-analysis，PMID 40553823）｜period: 檢索 2025-03，2025-09 刊出（現行最新版）｜geo: universal｜來源 S15｜span:「Data were extracted from seven clinical studies involving 151 partially dentate patients.」「Digital impressions demonstrated significantly lower deviation than conventional impressions, indicating superior spatial accuracy in certain clinical settings. However, no significant difference was observed in angular displacement. Considerable heterogeneity (I² = 80-97 %) across studies limits the certainty of pooled outcomes.」「Digital impressions are a clinically acceptable alternative for short-span implant restorations in partially dentate patients, though caution is warranted in cases involving long-span or angulated implants.」｜caveat: 限部分缺牙病人、樣本小、異質性很高；本卡不以此推薦任何掃描設備或品牌，取模方式屬臨床判斷。
  • F23｜confidence: verified｜basis: peer_reviewed（systematic review・meta-analysis，PMID 33678434，12 篇納入）｜period: 檢索 2020-09-23，2022 刊出｜geo: universal｜來源 S16｜span:「Twelve studies met the inclusion criteria for qualitative and quantitative analysis.」「Digital scanning was more time-efficient and was preferred by patients for all 4 analyzed outcomes (comfort, anxiety, nausea, time perception).」｜caveat: 結果為病人感受與作業時間，非臨床成功率；不同研究的掃描系統與操作者經驗不一。
  • F24｜confidence: verified｜basis: peer_reviewed（systematic review，PMID 24660192，73 篇納入）｜period: 檢索 2000 至 2012-09，2014 刊出｜geo: universal｜來源 S17｜span:「Five-year survival rates of 96.03% (95% confidence interval [CI]: 93.85% to 97.43%) and 95.55% (95% CI: 92.96% to 97.19%) were calculated for cemented and screw-retained reconstructions, respectively (P = .69).」「Although no statistical difference was found between cement- and screw-retained reconstructions for survival or failure rates, screw-retained reconstructions exhibited fewer technical and biologic complications overall.」｜caveat: 存活率為研究層級估計、非個人層級之承諾；檢索窗較舊，材料世代已變，故本卡並列較新的 F25。
  • F25｜confidence: verified｜basis: peer_reviewed（systematic review・meta-analysis，PMID 38263555）｜period: 檢索 2014-01 至 2023-06，2024 刊出｜geo: universal｜來源 S18｜span:「A total of eight studies were included for qualitative synthesis and six studies for quantitative synthesis.」「The evidence suggests that the screw-retained group showed no statistically significant difference in marginal bone level, comparatively fewer biological complications, and relatively higher technical complications than the cemented group at different follow-up periods.」｜caveat: 限氧化鋯基台之全瓷冠、樣本數小；與 F24 在「技術性併發症」方向不一致，本卡並列呈現、不擇一宣稱。
  • F26｜confidence: verified｜basis: peer_reviewed（systematic review・meta-analysis，PMID 33433078）｜period: 2021 刊出｜geo: universal｜來源 S19｜span:「Five trials, with 1,570 implants in 617 patients, met the inclusion criteria.」「SPIT can significantly reduce the rate of peri-implantitis and marginal bone loss.」「The evidence on the role of SPIT in reducing the rate of peri-implant mucositis, on the other hand, remains limited.」｜caveat: 納入 5 篇試驗（含回溯性研究），作者自陳仍需更多良好設計的研究；為族群層級關聯，非個人層級之承諾。
  • F27｜confidence: verified｜basis: peer_reviewed（systematic review・meta-analysis，PMID 26701350）｜period: 檢索至 2015-06，2016 刊出；本卡已另引 2021 年同主題回顧（F26）作為較新證據｜geo: universal｜來源 S20｜span:「Thirteen and 10 clinical trials were included in the qualitative and quantitative analysis, respectively.」「it can be concluded that implant therapy must not be limited to the placement and restoration of dental implants but to the implementation of PIMT to potentially prevent biologic complications and hence to heighten the long-term success rate.」「Although it must be tailored to a patient's risk profiling, our findings suggest reason to claim a minimum recall PIMT interval of 5 to 6 mo.」｜caveat: 「5 至 6 個月」為該回顧作者的建議下限並自陳須依風險輪廓調整，不是對任何病人的回診承諾；回診間隔由主治牙醫師決定。
  • F28｜confidence: verified｜basis: peer_reviewed（比較性研究，PMID 26970296，339 位病人）｜period: 2017 刊出｜geo: universal｜來源 S21｜span:「Healing outcomes of straightforward implant placement (I) were comparable to that of a simple extraction (SE)」「Prevalence for complications 1 week postoperatively was IGBR (20%), P (15.6%), I (12.7%)」｜caveat: 香港與南京兩中心、非隨機，屬群體層級走勢；本卡僅用作術後一週的座標，術後照護細節見 KM-DENTAL-20。同 KM-DENTAL-20 錨。
  • F29｜無外部來源｜basis: editorial（證據缺口與政策聲明，非待驗 claim）｜period: 2026-08-06｜geo: universal｜來源 S28｜本卡不提供以下內容：①任何金額或價格區間（本站政策，收費依各縣市核定標準與院所報價而定，見 F6、F7 與 KM-DENTAL-09） ②療程總天數或總月數的一般化承諾（取決於個別骨條件與治療計畫，見 F14、F15、F16） ③植入時機分型的週數時間窗（本次檢索取回的摘要未載，禁憑印象填入） ④任何設備、術式或品牌的優劣結論 ⑤任何用藥建議（屬醫師處方判斷，見 F4）。

來源清單

取用日期均為 2026-08-06；PubMed 條目以 E-utilities efetch 取得摘要原文並逐字比對，法規條文以 ego-browser 實際開啟頁面確認可達且逐字相符。

  • S1 Bornstein MM, Scarfe WC, Vaughn VM, Jacobs R. Cone beam computed tomography in implant dentistry: a systematic review focusing on guidelines, indications, and radiation dose risks. Int J Oral Maxillofac Implants. 2014;29 Suppl:55-77. PMID 24660190. pubmed.ncbi.nlm.nih.gov/24660190
  • S2 Galarraga-Vinueza ME, Pagni S, Finkelman M, et al. Prevalence, incidence, systemic, behavioral, and patient-related risk factors and indicators for peri-implant diseases: An AO/AAP systematic review and meta-analysis. J Periodontol. 2025;96(6):587-633. PMID 40489307. pubmed.ncbi.nlm.nih.gov/40489307
  • S3 Chen ST, Buser D. Clinical and esthetic outcomes of implants placed in postextraction sites. Int J Oral Maxillofac Implants. 2009;24 Suppl:186-217. PMID 19885446. pubmed.ncbi.nlm.nih.gov/19885446
  • S4 Atieh MA, Alsabeeha NH, Payne AG, Ali S, Faggion CM Jr, Esposito M. Interventions for replacing missing teeth: alveolar ridge preservation techniques for dental implant site development. Cochrane Database Syst Rev. 2021;4(4):CD010176. PMID 33899930. pubmed.ncbi.nlm.nih.gov/33899930
  • S5 Naenni N, Lim HC, Papageorgiou SN, Hämmerle CHF. Efficacy of lateral bone augmentation prior to implant placement: A systematic review and meta-analysis. J Clin Periodontol. 2019;46 Suppl 21:287-306. PMID 30624791. pubmed.ncbi.nlm.nih.gov/30624791
  • S6 Khaohoen A, Powcharoen W, Yoda N, Rungsiyakull C, Rungsiyakull P. Accuracy in dental implant placement: A systematic review and meta-analysis comparing computer-assisted and noncomputer-assisted approaches. J Prosthet Dent. 2025;134(1):91.e1-91.e25. PMID 40221370. pubmed.ncbi.nlm.nih.gov/40221370
  • S7 Esposito M, Grusovin MG, Maghaireh H, Worthington HV. Interventions for replacing missing teeth: different times for loading dental implants. Cochrane Database Syst Rev. 2013;(3):CD003878. PMID 23543525. pubmed.ncbi.nlm.nih.gov/23543525（版本鏈查證：CD003878 於 PubMed 得 5 筆版本，2013 年為現行最新版，無更新版、無撤回標記）
  • S8 Benic GI, Mir-Mari J, Hämmerle CH. Loading protocols for single-implant crowns: a systematic review and meta-analysis. Int J Oral Maxillofac Implants. 2014;29 Suppl:222-238. PMID 24660200. pubmed.ncbi.nlm.nih.gov/24660200
  • S9 Gallucci GO, Hamilton A, Akhondi S, Pala K, Peña-Cardelles JF. Current State of Evidence for Implant Placement and Loading in Partially Edentulous Patients: A Systematic Review. Clin Implant Dent Relat Res. 2026;28(1):e70120. PMID 41574557. pubmed.ncbi.nlm.nih.gov/41574557（為 PMID 30328194 之更新版，本卡採此版）
  • S10 Morton D, Wismeijer D, Chen S, et al. Group 5 ITI Consensus Report: Implant placement and loading protocols. Clin Oral Implants Res. 2023;34 Suppl 26:349-356. PMID 37750529. pubmed.ncbi.nlm.nih.gov/37750529
  • S11 Esposito M, Grusovin MG, Chew YS, Coulthard P, Worthington HV. WITHDRAWN: Interventions for replacing missing teeth: 1- versus 2-stage implant placement. Cochrane Database Syst Rev. 2018;5(5):CD006698. PMID 29791009. pubmed.ncbi.nlm.nih.gov/29791009（撤回文獻，僅作證據缺口記錄，不作臨床證據）
  • S12 Troiano G, Lo Russo L, Canullo L, Ciavarella D, Lo Muzio L, Laino L. Early and late implant failure of submerged versus non-submerged implant healing: A systematic review, meta-analysis and trial sequential analysis. J Clin Periodontol. 2018;45(5):613-623. PMID 29574852. pubmed.ncbi.nlm.nih.gov/29574852
  • S13 Moustafa Ali RM, Alqutaibi AY, El-Din Gomaa AS, Abdallah MF. Effect of Submerged vs Nonsubmerged Implant Placement Protocols on Implant Failure and Marginal Bone Loss: A Systematic Review and Meta-Analysis. Int J Prosthodont. 2018;31(1):15-22. PMID 29316568. pubmed.ncbi.nlm.nih.gov/29316568
  • S14 Bassetti RG, Stähli A, Bassetti MA, Sculean A. Soft tissue augmentation procedures at second-stage surgery: a systematic review. Clin Oral Investig. 2016;20(7):1369-1387. PMID 27041111. pubmed.ncbi.nlm.nih.gov/27041111
  • S15 Park JS, Alshehri YFA, Kruger E, Villata L. Accuracy of digital versus conventional implant impressions in partially dentate patients: A systematic review and meta-analysis. J Dent. 2025;160:105918. PMID 40553823. pubmed.ncbi.nlm.nih.gov/40553823
  • S16 Manicone PF, De Angelis P, Rella E, Damis G, D'Addona A. Patient preference and clinical working time between digital scanning and conventional impression making for implant-supported prostheses: A systematic review and meta-analysis. J Prosthet Dent. 2022;128(4):589-596. PMID 33678434. pubmed.ncbi.nlm.nih.gov/33678434
  • S17 Wittneben JG, Millen C, Brägger U. Clinical performance of screw- versus cement-retained fixed implant-supported reconstructions--a systematic review. Int J Oral Maxillofac Implants. 2014;29 Suppl:84-98. PMID 24660192. pubmed.ncbi.nlm.nih.gov/24660192
  • S18 Potdukhe SS, Iyer JM, Nadgere JB. Evaluation of marginal bone level, technical and biological complications between screw-retained and cement-retained implant-supported crowns. J Indian Prosthodont Soc. 2024;24(1):3-13. PMID 38263555. pubmed.ncbi.nlm.nih.gov/38263555
  • S19 Atieh MA, AlAli F, Alsabeeha NHM. Outcome of supportive peri-implant therapy on the rates of peri-implant diseases and marginal bone loss: a systematic review and meta-analysis. Quintessence Int. 2021;52(2):122-131. PMID 33433078. pubmed.ncbi.nlm.nih.gov/33433078
  • S20 Monje A, Aranda L, Diaz KT, et al. Impact of Maintenance Therapy for the Prevention of Peri-implant Diseases: A Systematic Review and Meta-analysis. J Dent Res. 2016;95(4):372-379. PMID 26701350. pubmed.ncbi.nlm.nih.gov/26701350
  • S21 Yao J, Lee KK, McGrath C, et al. Comparison of patient-centered outcomes after routine implant placement, teeth extraction, and periodontal surgical procedures. Clin Oral Implants Res. 2017;28(4):373-380. PMID 26970296. pubmed.ncbi.nlm.nih.gov/26970296
  • S22 醫療法 第 63 條（全國法規資料庫）。law.moj.gov.tw pcode=L0020021 flno=63（2026-08-06 以 ego-browser 實測可達，條文逐字對得上）
  • S23 醫療法 第 81 條（全國法規資料庫）。law.moj.gov.tw pcode=L0020021 flno=81（2026-08-06 實測可達，逐字對得上）
  • S24 醫療法 第 87 條（全國法規資料庫）。law.moj.gov.tw pcode=L0020021 flno=87（2026-08-06 實測可達，逐字對得上）
  • S25 醫療法 第 21 條（全國法規資料庫）。law.moj.gov.tw pcode=L0020021 flno=21（2026-08-06 實測可達，逐字對得上）
  • S26 全民健康保險法 第 51 條（全國法規資料庫）。law.moj.gov.tw pcode=L0060001 flno=51（2026-08-06 實測可達，第 11 款逐字對得上）
  • S27 內部資料：`analysis/reports/km-dental-backlog.md` 第 25 題附錄（14 診所站 GSC 全量，資料窗 2025-03～2026-08），6 詞項跨 5 站，逐筆可對帳。非醫學事實 basis，僅為選題依據。
  • S28 編輯框架（無外部來源）：本卡的九關時間軸、checklist 八題與證據缺口聲明，見 F2、F29。

內部引用鏈

發布閘門提醒：本卡為 draft。四語（zh-Hans／en／ja）未產前不得進 km_entries；F18 為撤回文獻記錄，若日後 Cochrane 重新發表該題回顧，須改寫該段而非保留「已撤回」字樣。

FAQ

植牙從頭到尾要多久？
沒有通用天數。文獻能給的是骨整合期的描述性框架：植體傳統上會有 3 至 8 個月不受力以建立骨整合，而負載時機分成立即（一週內）、早期（一週至兩個月）與傳統（兩個月後）三類[F14]。你的總長度取決於是否拔牙、是否補骨、採哪一種植入與負載組合、是否需要二階手術，以及上部假牙的複雜度[F10][F11][F16][F19][F22]。請要求醫師針對你的計畫給出階段安排[F4]。
インプラントは最初から最後までどのくらいかかりますか？ — 共通の日数はありません。文献が示せるのは、オッセオインテグレーション期の説明的な枠組みです。インプラントはオッセオインテグレーションを確立するため伝統的には 3 〜 8 か月無負荷で置かれ、負荷時期は即時（1 週間以内）、早期（1 週間から 2 か月）、従来（2 か月後）の 3 類型です。[F14] 総期間は、抜歯するか、骨造成をするか、どの埋入・負荷の組合せを使うか、二次手術が必要か、上部補綴物の複雑さで決まります。[F10][F11][F16][F19][F22] 自分の計画に沿った段階別の予定を医師に求めてください。[F4]
How long does implant treatment take from start to finish? — There is no universal number of days. The literature provides a descriptive framework for osseointegration: implants have traditionally been kept load-free for 3 to 8 months to establish osseointegration, and loading is classified as immediate (within one week), early (between one week and two months), or conventional (after two months).[F14] Your total length depends on extraction, bone augmentation, the placement-and-loading combination, whether second-stage surgery is needed, and the complexity of the superstructure prosthesis.[F10][F11][F16][F19][F22] Ask the physician to give you a stage-by-stage plan for your case.[F4]
為什麼有人「當天就能有牙」，我卻要等？
因為那是條件題。單顆植體牙冠的統合分析結論指出，立即負載與傳統負載在植體存活與邊緣骨流失上表現相當，但該結論主要來自植入扭力達 20 至 45 Ncm 以上或植體穩定度商數達 60 至 65 以上、且不需同時補骨的病例[F15]。2023 年 ITI 共識報告也把「立即植入加立即負載」的可預期性限定在上顎前牙區且條件有利的情形，並指出併發症仍可能發生[F17]。
「当日に歯が入る」人がいるのに、なぜ私は待つのですか？ — それは条件の問題だからです。単独インプラント冠のメタ解析は、即時負荷と従来負荷がインプラント存留と辺縁骨喪失で同程度と結論しましたが、その結論は主に、埋入トルクが 20 〜 45 Ncm 以上またはインプラント安定度指数が 60 〜 65 以上で、同時の骨造成を要しない症例に由来します。[F15] 2023 年 ITI コンセンサス報告も、「即時埋入＋即時負荷」の予測可能性を上顎前歯部で条件が良好な場合に限り、合併症はなお起こり得ると述べています。[F17]
Why can someone else “have a tooth the same day” while I have to wait? — Because it is a question of conditions. A meta-analysis of single-implant crowns concluded that immediate and conventional loading have comparable implant survival and marginal bone loss, but that conclusion mainly came from cases with insertion torque of at least 20 to 45 Ncm or an implant stability quotient of at least 60 to 65, and no simultaneous bone augmentation.[F15] The 2023 ITI Consensus Report also limits the predictability of “immediate placement plus immediate loading” to favorable conditions in the anterior maxilla and says complications can still occur.[F17]
一定要等拔牙傷口完全好才能植嗎？
不一定，文獻把拔牙後的植入時機分為立即（第 1 型）、早期（第 2、3 型）與延遲（第 4 型）四型，多數研究回報的存活率高於 95%[F10]。但各型的取捨不同：立即植入的唇頰側黏膜緣退縮較常見，早期植入的黏膜退縮頻率較立即植入低[F10]。選哪一型由牙醫師依你的條件判斷。
抜歯創が完全に治ってからでないと埋入できませんか？ — 必ずしもそうではありません。文献は抜歯後の埋入時期を、即時（第 1 型）、早期（第 2・3 型）、遅延（第 4 型）の 4 型に分け、多くの研究は存留率が 95% を上回ったと報告しています。[F10] ただし各型には異なる取捨選択があります。頬側粘膜縁の退縮は即時埋入でよりよく見られ、早期埋入の粘膜退縮頻度は即時埋入より低いとされています。[F10] どの型を選ぶかは歯科医師があなたの条件により判断します。
Must I wait until the extraction wound is completely healed before an implant? — Not necessarily. The literature classifies placement after extraction into four types: immediate (type 1), early (types 2 and 3), and late (type 4); most studies reported survival rates above 95%.[F10] But the trade-offs differ: facial mucosal-margin recession is more common with immediate placement, whereas early placement has a lower frequency of mucosal recession than immediate placement.[F10] Your dentist chooses the type according to your conditions.

來源錨定

引用本文

km 編輯部・《植牙全過程：從評估到裝上牙冠，會經歷哪幾關？｜證據鏈》・IDAEO 知識庫・2026-08-13・https://km.idaeo.ai/post/reports/dental-implant-process-evidence

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更新 2026-08-13T14:17:18.482Z · server-rendered · four-language · IDAEO 知識庫