Heydenrijk Kees, Raghoebar Gerry M, Meijer Henny J A, van der Reijden Willy A, van Winkelhoff Arie Jan, Stegenga Boudewijn
Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthetics, University Hospital Groningen, The Netherlands.
Clin Oral Implants Res. 2002 Aug;13(4):371-80. doi: 10.1034/j.1600-0501.2002.130405.x.
The aim of this study was to evaluate the feasibility of using a two-stage implant system in a single-stage procedure and to study the impact of the microgap at crestal level and to monitor the microflora in the peri-implant area. Forty edentulous patients (Cawood & Howell class V-VI) participated in this study. After randomisation, 20 patients received two IMZ implants inserted in a single-stage procedure and 20 patients received two ITI implants. After 3 months, overdentures were fabricated, supported by a bar and clip attachment. A standardised clinical and radiographic evaluation was performed immediately after denture insertion and 6 and 12 months later. Twelve months after loading, peri-implant samples were collected with sterile paper points and analysed for the presence of putative periodontal pathogens using culture techniques. One IMZ implant was lost due to insufficient osseointegration. With regard to the clinical parameters at the 12 months evaluation, significant differences for plaque score and probing pocket depth (IMZ: mean 3.3 mm, ITI: mean 2.9 mm) were found between the two groups. The mean bone loss in the first year of functioning was 0.6 mm for both groups. Prevotella intermedia was detected more often in the ITI group (12 implants) than in the IMZ group (three implants). Porphyromonas gingivalis was found in three patients. In one of these patients an implant showed bone loss of 1.6 mm between T0 and T12. Some associations were found between clinical parameters and the target microorganisms in the ITI group. These associations were not present in the IMZ group. The short-term results indicate that two-stage implants inserted in a single-stage procedure may be as predictable as one-stage implants. The microgap at crestal level in nonsubmerged IMZ implants seems to have no adverse influence on the peri-implant microbiological colonisation and of crestal bone loss in the first year of functioning. The peri-implant sulcus can and does harbour potential periodontal pathogens without signs of peri-implantitis during the evaluation period of 1 year.
本研究的目的是评估在单阶段手术中使用两阶段种植系统的可行性，研究种植体颈部微间隙的影响，并监测种植体周围区域的微生物群落。40例无牙患者（Cawood&Howell V-VI级）参与了本研究。随机分组后，20例患者在单阶段手术中植入两枚IMZ种植体，20例患者植入两枚ITI种植体。3个月后，制作覆盖义齿，由杆卡式附着体支持。在义齿植入后即刻以及6个月和12个月后进行标准化的临床和影像学评估。加载12个月后，用无菌纸尖采集种植体周围样本，采用培养技术分析是否存在假定的牙周病原体。一枚IMZ种植体因骨结合不足而脱落。在12个月评估时的临床参数方面，两组之间的菌斑评分和探诊袋深度存在显著差异（IMZ：平均3.3mm，ITI：平均2.9mm）。两组在功能第一年的平均骨吸收均为0.6mm。中间普氏菌在ITI组（12枚种植体）中的检出率高于IMZ组（3枚种植体）。牙龈卟啉单胞菌在3例患者中被发现。其中1例患者的一枚种植体在T0至T12期间骨吸收达1.6mm。在ITI组中发现临床参数与目标微生物之间存在一些关联。这些关联在IMZ组中不存在。短期结果表明，在单阶段手术中植入的两阶段种植体可能与一阶段种植体一样具有可预测性。未潜入式IMZ种植体颈部的微间隙似乎对种植体周围微生物定植和功能第一年的种植体颈部骨吸收没有不利影响。在1年的评估期内，种植体周围龈沟能够且确实存在潜在的牙周病原体，但无种植体周炎迹象。
