King Gaston N, Hermann Joachim S, Schoolfield John D, Buser Daniel, Cochran David L
Department of Periodontics, Dental School, University of Texas Health Science Center, San Antonio 78229-3900, USA.
J Periodontol. 2002 Oct;73(10):1111-7. doi: 10.1902/jop.2002.73.10.1111.
Accumulating evidence suggests that alveolar crestal bone resorption occurs as a result of the microgap that is present between the implant-abutment interface in dental implants. The objective of this longitudinal radiographic study was to determine whether the size of the interface or the microgap between the implant and abutment influences the amount of crestal bone loss in unloaded non-submerged implants.
Sixty titanium implants having sandblasted with large grit, acid-etched (SLA) endosseous surfaces were placed in edentulous mandibular areas of 5 American fox hounds. Implant groups A, B, and C had a microgap between the implant-abutment connection of <10 microm, 50 microm, or 100 microm, respectively, as did groups D, E, and F, respectively. Abutments were either welded (1 -piece) in groups A, B, and C or non-welded (2-piece screwed) in D, E, and F. All abutment interfaces were placed 1 mm above the alveolar crest. Radiographic assessment was undertaken to evaluate peri-implant crestal bone levels at baseline and at 1, 2, and 3 months after implant placement whereupon all animals were sacrificed.
The size of the microgap at the abutment/implant interface had no significant effect upon crestal bone loss. At 1 month, most implants developed crestal bone loss compared with baseline levels. However, during this early healing period, the non-welded group (D, E, and F) showed significantly greater crestal bone loss from baseline to one month (P <0.04) and 2 months (P < 0.02) compared with the welded group (A, B, and C). No significant differences were observed between these 2 groups at 3 months (P > 0.70).
Crestal bone loss was an early manifestation of wound healing occurring after 1 month of implant placement. However, the size of the microgap at the implant-abutment interface had no significant effect upon crestal bone resorption. Thus, 2-piece non-welded implants showed significantly greater crestal bone loss compared with 1-piece welded implants after 1 and 2 months suggesting that the stability of the implant/abutment interface may have an important early role to play in determining crestal bone levels. At 3 months, this influence followed a similar trend but was not observed to be statistically significant. This finding implies that implant configurations incorporating interfaces will be associated with biological changes regardless of interface size and that mobility between components may have an early influence on wound healing around the implant.
越来越多的证据表明，牙槽嵴顶骨吸收是由于牙种植体中种植体-基台界面存在微间隙所致。这项纵向影像学研究的目的是确定界面大小或种植体与基台之间的微间隙是否会影响未加载的非潜入式种植体的嵴顶骨吸收量。
将60颗具有大颗粒喷砂、酸蚀（SLA）骨内表面的钛种植体植入5只美国猎狐犬的无牙下颌区域。种植体A、B和C组的种植体-基台连接处的微间隙分别<10微米、50微米或100微米，D、E和F组也是如此。A、B和C组的基台采用焊接（一体式），D、E和F组采用非焊接（两件式螺纹连接）。所有基台界面均置于牙槽嵴顶上方1毫米处。在基线时以及种植体植入后1、2和3个月进行影像学评估，以评估种植体周围的嵴顶骨水平，之后对所有动物实施安乐死。
基台/种植体界面处微间隙的大小对嵴顶骨吸收没有显著影响。在1个月时，与基线水平相比，大多数种植体出现了嵴顶骨吸收。然而，在这个早期愈合阶段，与焊接组（A、B和C组）相比，非焊接组（D、E和F组）从基线到1个月（P<0.04）和2个月（P<0.02）的嵴顶骨吸收明显更多。在3个月时，这两组之间未观察到显著差异（P>0.70）。
嵴顶骨吸收是种植体植入1个月后伤口愈合的早期表现。然而，种植体-基台界面处微间隙的大小对嵴顶骨吸收没有显著影响。因此，两件式非焊接种植体在1个月和2个月后显示出比一体式焊接种植体明显更多的嵴顶骨吸收，这表明种植体/基台界面的稳定性在确定嵴顶骨水平方面可能在早期起着重要作用。在3个月时，这种影响遵循类似趋势，但未观察到具有统计学意义。这一发现意味着，无论界面大小如何，包含界面的种植体构型都会伴随着生物学变化，并且部件之间的移动性可能会对种植体周围的伤口愈合产生早期影响。
