Khang W, Feldman S, Hawley C E, Gunsolley J
University of Maryland, Baltimore, Baltimore, MD, USA.
J Periodontol. 2001 Oct;72(10):1384-90. doi: 10.1902/jop.2001.72.10.1384.
A major reason for the success of modern dental implant systems has been the development of implant designs that enhance direct bone-implant interface. Surface roughness has been a factor in this success and different systems have utilized very different implant surface roughness. The major purpose of this study was to evaluate 2 similar implants with different surface roughness characteristics.
Two similarly designed, screw-type, commercially pure titanium implants, one dual acid-etched (DAE) and the other machined-surfaced (MS), were compared in this prospective, randomized-controlled, multi-center study, in which a total of 97 patients were enrolled at a private dental practice or a university dental clinic. Both implant types were placed in each patient using a 2-stage approach with a conventional 4- to 6-month healing period. Implants supported fixed prostheses, hybrid prostheses, and overdentures as dictated by the individual patient's need. All of the cases were followed using clinical and radiographic examinations. Criteria of success were the absence of peri-implant radiolucency, mobility, and persistent signs or symptoms of pain or infection.
Of the 432 implants (247 dual acid-etched, 185 machined-surfaced), 36 implants (12 dual acid-etched and 24 machined-surfaced) have failed. The pre-loading integration success rate of the dual acid-etched implants (95.0%) was statistically higher (P < 0.01) than the success rate of the machined-surfaced implants (86.7%). At 36 months, the cumulative success rates (CSR) are 95.0% for the dual acid-etched implants and 86.7% for the machined-surfaced implants.
The difference in success rates is most likely attributed to the acid-etched surface characteristics. The greatest performance difference is observed in the conditions of poor quality or soft bone where the 3-year post-loading CSR are 96.8% (dual acid-etched) and 84.8% (machined-surfaced).
现代牙种植系统成功的一个主要原因是种植体设计的发展，这种设计增强了骨与种植体的直接界面。表面粗糙度是促成这一成功的一个因素，不同的系统采用了截然不同的种植体表面粗糙度。本研究的主要目的是评估两种具有不同表面粗糙度特征的相似种植体。
在这项前瞻性、随机对照、多中心研究中，比较了两种设计相似的螺纹型商业纯钛种植体，一种是双重酸蚀（DAE）种植体，另一种是机械加工表面（MS）种植体，共有97名患者在一家私立牙科诊所或大学牙科诊所登记入组。两种种植体均采用两阶段方法植入每位患者体内，愈合期为常规的4至6个月。种植体根据患者个体需求支持固定义齿、混合义齿和覆盖义齿。所有病例均通过临床和影像学检查进行随访。成功标准为种植体周围无透射影、无松动，以及无持续的疼痛或感染体征或症状。
在432颗种植体（247颗双重酸蚀种植体、185颗机械加工表面种植体）中，有36颗种植体（12颗双重酸蚀种植体和24颗机械加工表面种植体）失败。双重酸蚀种植体的预加载整合成功率（95.0%）在统计学上高于机械加工表面种植体的成功率（86.7%）（P < 0.01）。在36个月时，双重酸蚀种植体的累积成功率（CSR）为95.0%，机械加工表面种植体的累积成功率为86.7%。
成功率的差异很可能归因于酸蚀表面特征。在骨质质量差或骨质疏松的情况下，观察到的性能差异最大，此时加载后3年的累积成功率分别为96.8%（双重酸蚀种植体）和84.8%（机械加工表面种植体）。
