植牙全过程:从评估到装上牙冠,会经历哪几关?|證據鏈
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植牙全过程:从评估到装上牙冠,会经历哪几关?|證據鏈
F-Units(事实单元帐)
每条标明 confidence/basis/period/geo/逐字 span/caveat。basis 阶梯:law > official_statement > clinical_guideline > peer_reviewed > textbook;撤回文献标 withdrawn_publication/not_evidence,不作临床证据。
- F1|confidence: high|basis: internal_dataset(非医学 basis)|period: GSC 保留窗(2025-03 起)|geo: TW|来源 S27|本题查询族共 6 个词项、跨 5 个站,逐笔可对帐;选题证据数值保留于草稿 frontmatter 与内部档案,发布转档时不进可见层(2026-08-05 裁定)。
- F2|无外部来源|basis: editorial_framework(结构性整理,非事实宣称,不得标为待验)|period: 2026-08-06|geo: universal|来源 S28|「九关」时间轴、checklist 八题与「这张卡管什么」的分工声明,均为本站依 F3 至 F28 文献与法规整理的沟通用结构,不是官方分类,也不是临床指引。
- F3|confidence: verified(2026-08-06 以 ego-browser 实测可达,条文逐字对得上)|basis: law(医疗法第 63 条)|period: 现行条文|geo: TW|来源 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 实测,逐字对得上)|basis: law(医疗法第 81 条)|period: 现行条文|geo: TW|来源 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 实测,逐字对得上)|basis: law(医疗法第 87 条第 2 项)|period: 现行条文|geo: TW|来源 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 实测,逐字对得上)|basis: law(医疗法第 21 条)|period: 现行条文|geo: TW|来源 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 实测,第 11 款逐字对得上)|basis: law(全民健康保险法第 51 条第 11 款)|period: 现行条文|geo: TW|来源 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: 检索至 2012-10-31,2014 刊出;检索日 2026-08-06|geo: universal|来源 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|来源 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;盛行率為人群層級數字,非個人機率。同 KM-DENTAL-20 錨。
- F10|confidence: verified|basis: peer_reviewed(systematic review,PMID 19885446,91 篇纳入)|period: 2009 刊出;检索日 2026-08-06,本卡另引 2018 与 2026 年同主题回顾(F16)互相校正,本条仅用于植入时机的分型与软组织结果|geo: universal|来源 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;存留率為研究層級估計,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: 检索至 2021-03-19,2021 刊出;为 2015 年初版之更新版,检索日 2026-08-06 未见更新的 pub4|geo: universal|来源 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: 检索至 2018-05,2019 刊出|geo: universal|来源 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: 检索至 2024-08,2025 刊出|geo: universal|来源 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留率;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: 检索至 2012-06,2013 刊出;版本链查证 2026-08-06:PubMed 以 CD003878 检索得 5 笔版本(2003/2004/2007/2009/2013),2013 年版为现行最新版,MEDLINE 记录无 UIN(无更新版)、无撤回标记,pubtype 不含 Retracted Publication|geo: universal|来源 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: 检索至 2012-08,2014 刊出|geo: universal|来源 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;时效查证 2026-08-06:本篇为同一团队 2018 年版(PMID 30328194)的更新版,本卡改采此版并停用旧版数字;pubtype 为 Journal Article/Systematic Review,不含 Retracted Publication|geo: universal|来源 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: 加權累積存留率為研究層級估計、非個人成功率之承諾;本卡刻意不逐一列出各組合的存留率數值,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|来源 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(记录用)|basis: withdrawn_publication/not_evidence(PMID 29791009,Cochrane Database Syst Rev. 2018;5(5):CD006698,标题含 WITHDRAWN)|period: 2018-05-23 撤回|geo: universal|来源 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 篇纳入)|period: 2018-05 刊出|geo: universal|来源 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 篇随机试验纳入分析)|period: 2018 刊出|geo: universal|来源 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: 检索至 2015-07-31,2016 刊出|geo: universal|来源 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: 检索 2025-03,2025-09 刊出(现行最新版)|geo: universal|来源 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 篇纳入)|period: 检索 2020-09-23,2022 刊出|geo: universal|来源 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 篇纳入)|period: 检索 2000 至 2012-09,2014 刊出|geo: universal|来源 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: 存留率為研究層級估計、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: 检索 2014-01 至 2023-06,2024 刊出|geo: universal|来源 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|来源 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;為人群層級關聯,非個人層級之承諾。
- F27|confidence: verified|basis: peer_reviewed(systematic review・meta-analysis,PMID 26701350)|period: 检索至 2015-06,2016 刊出;本卡已另引 2021 年同主题回顾(F26)作为较新证据|geo: universal|来源 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(比较性研究,PMID 26970296,339 位病人)|period: 2017 刊出|geo: universal|来源 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|无外部来源|basis: editorial(证据缺口与政策声明,非待验 claim)|period: 2026-08-06|geo: universal|来源 S28|本卡不提供以下内容:①任何金额或价格区间(本站政策,收费依各县市核定标准与院所报价而定,见 F6、F7 与 KM-DENTAL-09) ②疗程总天数或总月数的一般化承诺(取决于个别骨条件与治疗计划,见 F14、F15、F16) ③植入时机分型的周数时间窗(本次检索取回的摘要未载,禁凭印象填入) ④任何设备、术式或品牌的优劣结论 ⑤任何用药建议(属医师处方判断,见 F4)。
来源清单
取用日期均为 2026-08-06;PubMed 条目以 E-utilities efetch 取得摘要原文并逐字比对,法规条文以 ego-browser 实际开启页面确认可达且逐字相符。
- 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。
内部引用链
- 費用怎麼拆、報價單怎麼讀:植牙一顆到底多少錢?沒有公定價,但你可以看懂報價單(KM-DENTAL-09,草稿)。本卡階段一至階段三提到的影像、骨處理與手術方式,在該卡是報價拆項的變因;兩卡共用醫療法第 21 條與健保法第 51 條的台灣制度錨,逐字 span 一致。
- 手術完當天到那一週怎麼吃、咖啡能不能喝:植牙後多久能吃東西?咖啡跟茶可以喝嗎?(KM-DENTAL-20,草稿)。本卡階段四只給一個座標(F28),細節在該卡;兩卡共用負載時機錨(F14=該卡 F10、F15=該卡 F12)。
- 補骨是什麼、要不要做:補骨粉是什麼?費用多少、會痛嗎?(KM-DENTAL-24,草稿)。
- 補骨的併發症與失敗徵象分級:補骨粉會有後遺症嗎?失敗了會怎樣?(KM-DENTAL-28,草稿)。本卡階段三只交代它會不會拉長療程,併發症面向見該卡。
- 決策前的期望校正與長期併發症:植牙會後悔嗎?網友的慘痛經驗是真的嗎?(KM-DENTAL-07,草稿)。本卡階段九引用的植體周圍疾病盛行率(F9)與該卡共用同一族錨。
发布闸门提醒:本卡为 draft。四语(zh-Hans/en/ja)未产前不得进 km_entries;F18 为撤回文献记录,若日后 Cochrane 重新发表该题回顾,须改写该段而非保留「已撤回」字样。
FAQ
- 植牙从头到尾要多久?
- 没有通用天数。文献能给的是骨整合期的描述性框架:植体传统上会有 3 至 8 个月不受力以建立骨整合,而负载时机分成立即(一周内)、早期(一周至两个月)与传统(两个月后)三类[F14]。你的总长度取决于是否拔牙、是否植骨、采哪一种植入与负载组合、是否需要二阶手术,以及上部假牙的复杂度[F10][F11][F16][F19][F22]。请要求医师针对你的计划给出阶段安排[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]
- 为什么有人「当天就能有牙」,我却要等?
- 因为那是条件题。单颗植体牙冠的统合分析结论指出,立即负载与传统负载在植体存活与边缘骨流失上表现相当,但该结论主要来自植入扭力达 20 至 45 Ncm 以上或植体稳定度商数达 60 至 65 以上、且不需同时植骨的病例[F15]。2023 年 ITI 共识报告也把「立即植入加立即负载」的可预期性限定在上颚前牙区且条件有利的情形,并指出并发症仍可能发生[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]
- 一定要等拔牙伤口完全好才能植吗?
- 不一定,文献把拔牙后的植入时机分为立即(第 1 型)、早期(第 2、3 型)与延迟(第 4 型)四型,多数研究回报的存留率高于 95%[F10]。但各型的取舍不同:立即植入的唇颊侧黏膜缘退缩较常见,早期植入的黏膜退缩频率较立即植入低[F10]。选哪一型由牙医师依你的条件判断。
- 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.
来源锚定
- Bornstein MM, Scarfe WC, Vaughn VM, Jacobs R. Cone beam computed tomography in implant dentistry: a systematic review focusing on guidelines, indications… · https://pubmed.ncbi.nlm.nih.gov/24660190/ · 在 IDAEO 的其他引用
- Galarraga-Vinueza ME, Pagni S, Finkelman M, et al. Prevalence, incidence, systemic, behavioral, and patient-related risk factors and indicators for… · https://pubmed.ncbi.nlm.nih.gov/40489307/ · 在 IDAEO 的其他引用
- 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… · https://pubmed.ncbi.nlm.nih.gov/19885446/ · 在 IDAEO 的其他引用
- Atieh MA, Alsabeeha NH, Payne AG, Ali S, Faggion CM Jr, Esposito M. Interventions for replacing missing teeth: alveolar ridge preservation techniques for… · https://pubmed.ncbi.nlm.nih.gov/33899930/ · 在 IDAEO 的其他引用
- Naenni N, Lim HC, Papageorgiou SN, Hämmerle CHF. Efficacy of lateral bone augmentation prior to implant placement: A systematic review and meta-analysis. J… · https://pubmed.ncbi.nlm.nih.gov/30624791/ · 在 IDAEO 的其他引用
- Khaohoen A, Powcharoen W, Yoda N, Rungsiyakull C, Rungsiyakull P. Accuracy in dental implant placement: A systematic review and meta-analysis comparing… · https://pubmed.ncbi.nlm.nih.gov/40221370/ · 在 IDAEO 的其他引用
- Esposito M, Grusovin MG, Maghaireh H, Worthington HV. Interventions for replacing missing teeth: different times for loading dental implants. Cochrane… · https://pubmed.ncbi.nlm.nih.gov/23543525/ · 在 IDAEO 的其他引用
- Benic GI, Mir-Mari J, Hämmerle CH. Loading protocols for single-implant crowns: a systematic review and meta-analysis. Int J Oral Maxillofac Implants.… · https://pubmed.ncbi.nlm.nih.gov/24660200/ · 在 IDAEO 的其他引用
- Gallucci GO, Hamilton A, Akhondi S, Pala K, Peña-Cardelles JF. Current State of Evidence for Implant Placement and Loading in Partially Edentulous Patients:… · https://pubmed.ncbi.nlm.nih.gov/41574557/ · 在 IDAEO 的其他引用
- 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… · https://pubmed.ncbi.nlm.nih.gov/37750529/ · 在 IDAEO 的其他引用
- Esposito M, Grusovin MG, Chew YS, Coulthard P, Worthington HV. WITHDRAWN: Interventions for replacing missing teeth: 1- versus 2-stage implant placement.… · https://pubmed.ncbi.nlm.nih.gov/29791009/ · 在 IDAEO 的其他引用
- 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… · https://pubmed.ncbi.nlm.nih.gov/29574852/ · 在 IDAEO 的其他引用
- Moustafa Ali RM, Alqutaibi AY, El-Din Gomaa AS, Abdallah MF. Effect of Submerged vs Nonsubmerged Implant Placement Protocols on Implant Failure and Marginal… · https://pubmed.ncbi.nlm.nih.gov/29316568/ · 在 IDAEO 的其他引用
- Bassetti RG, Stähli A, Bassetti MA, Sculean A. Soft tissue augmentation procedures at second-stage surgery: a systematic review. Clin Oral Investig.… · https://pubmed.ncbi.nlm.nih.gov/27041111/ · 在 IDAEO 的其他引用
- Park JS, Alshehri YFA, Kruger E, Villata L. Accuracy of digital versus conventional implant impressions in partially dentate patients: A systematic review… · https://pubmed.ncbi.nlm.nih.gov/40553823/ · 在 IDAEO 的其他引用
- Manicone PF, De Angelis P, Rella E, Damis G, D'Addona A. Patient preference and clinical working time between digital scanning and conventional impression… · https://pubmed.ncbi.nlm.nih.gov/33678434/ · 在 IDAEO 的其他引用
- Wittneben JG, Millen C, Brägger U. Clinical performance of screw- versus cement-retained fixed implant-supported reconstructions--a systematic review. Int J… · https://pubmed.ncbi.nlm.nih.gov/24660192/ · 在 IDAEO 的其他引用
- Potdukhe SS, Iyer JM, Nadgere JB. Evaluation of marginal bone level, technical and biological complications between screw-retained and cement-retained… · https://pubmed.ncbi.nlm.nih.gov/38263555/ · 在 IDAEO 的其他引用
- 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… · https://pubmed.ncbi.nlm.nih.gov/33433078/ · 在 IDAEO 的其他引用
- 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… · https://pubmed.ncbi.nlm.nih.gov/26701350/ · 在 IDAEO 的其他引用
- Yao J, Lee KK, McGrath C, et al. Comparison of patient-centered outcomes after routine implant placement, teeth extraction, and periodontal surgical… · https://pubmed.ncbi.nlm.nih.gov/26970296/ · 在 IDAEO 的其他引用
- 醫療法 第 63 條(全國法規資料庫)。[law.moj.gov.tw pcode=L0020021 flno=63]( 以 ego-browser 實測可達,條文逐字對得上 · https://law.moj.gov.tw/LawClass/LawSingle.aspx?pcode=L0020021&flno=63 · 在 IDAEO 的其他引用
- 醫療法 第 81 條(全國法規資料庫)。[law.moj.gov.tw pcode=L0020021 flno=81]( 實測可達,逐字對得上 · https://law.moj.gov.tw/LawClass/LawSingle.aspx?pcode=L0020021&flno=81 · 在 IDAEO 的其他引用
- 醫療法 第 87 條(全國法規資料庫)。[law.moj.gov.tw pcode=L0020021 flno=87]( 實測可達,逐字對得上 · https://law.moj.gov.tw/LawClass/LawSingle.aspx?pcode=L0020021&flno=87 · 在 IDAEO 的其他引用
- 醫療法 第 21 條(全國法規資料庫)。[law.moj.gov.tw pcode=L0020021 flno=21]( 實測可達,逐字對得上 · https://law.moj.gov.tw/LawClass/LawSingle.aspx?pcode=L0020021&flno=21 · 在 IDAEO 的其他引用
- 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]( 實測可達,第 11 款逐字對得上 · https://law.moj.gov.tw/LawClass/LawSingle.aspx?pcode=L0060001&flno=51 · 在 IDAEO 的其他引用
引用本文
km 編輯部・《植牙全过程:从评估到装上牙冠,会经历哪几关?|證據鏈》・IDAEO 知識庫・2026-08-13・https://km.idaeo.ai/post/reports/dental-implant-process-evidence