Hänggi Michael P, Hänggi Daniel C, Schoolfield John D, Meyer Jürg, Cochran David L, Hermann Joachim S
Department of Preventive Dentistry and Oral Microbiology, University of Basel Dental School, Basel, Switzerland.
J Periodontol. 2005 May;76(5):791-802. doi: 10.1902/jop.2005.76.5.791.
Experimental studies demonstrated that peri-implant crestal hard and soft tissues are significantly influenced in their apico-coronal position by the rough/smooth implant border as well as the microgap/ interface between implant and abutment/restoration. The aim of this study was to evaluate radiographically the crestal bone level changes around two types of implants, one with a 2.8 mm smooth machined coronal length and the other with 1.8 mm collar.
In 68 patients, a total of 201 non-submerged titanium implants (101 with a 1.8 mm, 100 with a 2.8 mm long smooth coronal collar) were placed with their rough/smooth implant border at the bone crest level. From the day of surgery up until 3 years after implant placement crestal bone levels were analyzed digitally using standardized radiographs.
Bone remodeling was most pronounced during the unloaded, initial healing phase and did not significantly differ between the two types of implants over the entire observation period (P >0.20). Crestal bone loss for implants placed in patients with poor oral hygiene was significantly higher than in patients with adequate or good plaque control (P <0.005). Furthermore, a tendency for additional crestal bone loss was detected in the group of patients who had been diagnosed with aggressive periodontitis prior to implant placement (P = 0.058). In both types of implants, sand-blasted, large grit, acid-etched (SLA) surfaced implants tended to have slightly less crestal bone loss compared to titanium plasma-sprayed (TPS) surfaced implants, but the difference was not significant (P >0.30).
The implant design with the shorter smooth coronal collar had no additional bone loss and may help to reduce the risk of an exposed metal implant margin in areas of esthetic concern.
实验研究表明，种植体周围嵴顶软硬组织在其冠根向位置上受到种植体粗糙/光滑边界以及种植体与基台/修复体之间的微间隙/界面的显著影响。本研究的目的是通过影像学评估两种类型种植体周围嵴顶骨水平的变化，一种种植体的光滑加工冠部长度为2.8 mm，另一种为1.8 mm颈部。
在68例患者中，共植入201颗非潜入式钛种植体（101颗颈部为1.8 mm，100颗冠部光滑长度为2.8 mm），其粗糙/光滑种植体边界位于牙槽嵴顶水平。从手术当天到种植体植入后3年，使用标准化X光片对嵴顶骨水平进行数字化分析。
在无负载的初始愈合阶段，骨重塑最为明显，在整个观察期内，两种类型的种植体之间没有显著差异（P>0.20）。口腔卫生差的患者植入种植体后的嵴顶骨吸收明显高于菌斑控制良好或中等的患者（P<0.005）。此外，在种植体植入前被诊断为侵袭性牙周炎的患者组中，检测到有额外嵴顶骨吸收的趋势（P=0.058）。在两种类型的种植体中，与钛等离子喷涂（TPS）表面的种植体相比，喷砂、大颗粒、酸蚀（SLA）表面的种植体嵴顶骨吸收往往略少，但差异不显著（P>0.30）。
具有较短光滑冠部颈部的种植体设计不会增加骨吸收，并且可能有助于降低美学关注区域金属种植体边缘暴露的风险。
