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, Dental School, Faculty of Medical Sciences, University of Groningen, the Netherlands.
J Clin Periodontol. 2002 Oct;29(10):901-9. doi: 10.1034/j.1600-051x.2002.291005.x.
The aim of this study was to evaluate the feasibility of using a two-part implant system in a one-stage procedure and to monitor the microflora in the peri-implant area in relation to clinical and radiographic outcome.
After randomisation, 40 edentulous patients (Cawood & Howell class V-VI) received two IMZ implants in the anterior mandible inserted by either a one-stage (n = 20) or a two-stage (n = 20) surgical procedure for overdenture treatment. A standardised clinical and radiographic evaluation was performed after denture insertion as well as 6 and 12 months thereafter. Twelve months after loading, peri-implant samples were collected and analysed for the presence of putative periodontal pathogens using culture technique.
No striking differences were found between the two groups with regard to the clinical parameters during the evaluation period. The mean bone loss in the first year of functioning was 0.6 mm in both groups. With regard to the gingiva score, plaque score, bleeding score or bone loss between T0 and T12, no associations were found with the presence of the cultured microorganisms. An association was present between pockets >or= 4 mm and the presence of Peptostreptococcus micros in the two-stage group.
The short-term results indicate that two-part implants inserted in a one-stage procedure may be as predictable as inserted in the common two-stage procedure. The peri-implant sulcus can and does harbour potential periodontal pathogens without significant signs of tissue breakdown.
本研究旨在评估在一期手术中使用两部分式种植系统的可行性，并监测种植体周围区域的微生物群与临床和影像学结果的关系。
随机分组后，40例无牙患者（Cawood & Howell V-VI级）在下颌前部植入两颗IMZ种植体，采用一期手术（n = 20）或二期手术（n = 20）进行覆盖义齿治疗。在义齿植入后以及此后6个月和12个月进行标准化的临床和影像学评估。加载12个月后，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。
在评估期间，两组在临床参数方面未发现显著差异。两组在功能第一年的平均骨吸收均为0.6 mm。在T0和T12之间，关于牙龈评分、菌斑评分、出血评分或骨吸收，未发现与培养微生物的存在有相关性。在二期手术组中，深度≥4 mm的牙周袋与微小消化链球菌的存在之间存在关联。
短期结果表明，一期手术植入的两部分式种植体与常规二期手术植入的种植体一样具有可预测性。种植体周围龈沟能够且确实存在潜在的牙周病原体，而无明显的组织破坏迹象。
