De Kok Ingeborg J, Chang Sandra S, Moriarty John D, Cooper Lyndon F
Department of Prosthodontics, Bone Biology and Implant Therapy Laboratory, School of Dentistry, University of North Carolina, Chapel Hill, North Carolina 27599, USA.
Int J Oral Maxillofac Implants. 2006 May-Jun;21(3):405-12.
The aim of this retrospective study was to examine the peri-implant tissue status at immediately provisionalized anterior maxillary implants 12 to 30 months following tooth replacement.
This is a retrospective study of 43 microthreaded, TiO2 grit-blasted implants placed in healed ridges and immediate extraction sockets to restore maxillary anterior and premolar teeth in 28 patients. The cortical bone position relative to the implant reference point was evaluated at implant placement and 6 to 30 months following restoration. Radiographs were assessed using 7x magnification. The distance from the reference point to the cortical bone was measured to +/- 0.1 mm. The relationship of the peri-implant mucosa to the incisal edge of the definitive prosthesis was recorded.
Four implants in 3 individuals failed during the first 6 weeks following placement and provisional loading. Cortical bone adaptation from the time of implant placement up to 30 months following restoration ranged from 0.0 mm to 1.5 mm (average, 0.33 +/- 0.40 mm mesially and 0.28 +/- 0.37 mm distally). The mean radiographic measurements from the interproximal crestal bone to the contact point were 4.53 +/- -0.91 mm (mesial) and 4.06 +/- 0.98. Maintenance and growth of papilla was observed in this group of immediate provisionalized single-tooth implants. Definitive abutment or abutment screw loosening was not observed.
The linear clinical and radiographic measures of peri-implant tissue responses suggest that proper implant placement is followed by supracrestal biological width formation along the abutment and preservation of toothlike tissue contours. This may influence buccal peri-implant tissue dimensions.
Generalized maintenance of crestal bone and the increased soft tissue dimension with maintenance of peri-implant papilla were identified as expected outcomes for immediate loading/provisionalization of microthreaded, TiO2 grit-blasted implants. Control of peri-implant tissues can be achieved to provide predictable and esthetic treatment for anterior tooth replacement using dental implants.
本回顾性研究旨在检查上颌前牙种植体在即刻临时修复后12至30个月时的种植体周围组织状况。
本回顾性研究纳入了28例患者，共43枚微螺纹、钛酸锶喷砂处理的种植体，植入愈合的牙槽嵴和即刻拔牙窝内，用于修复上颌前牙和前磨牙。在种植体植入时以及修复后6至30个月评估皮质骨相对于种植体参考点的位置。使用7倍放大率评估X线片。测量参考点到皮质骨的距离，精确到±0.1毫米。记录种植体周围黏膜与最终修复体切缘的关系。
3例患者的4枚种植体在植入和临时加载后的前6周内失败。从种植体植入到修复后30个月，皮质骨的适应性变化范围为0.0毫米至1.5毫米（平均近中为0.33±0.40毫米，远中为0.28±0.37毫米）。从邻间嵴顶骨到接触点的平均X线测量值为4.53± -0.91毫米（近中）和4.06±0.98毫米。在这组即刻临时修复的单颗牙种植体中观察到龈乳头的维持和生长。未观察到最终基台或基台螺钉松动。
种植体周围组织反应的线性临床和影像学测量表明，正确植入种植体后，沿基台会形成龈上生物宽度，并保留类牙组织轮廓。这可能会影响种植体颊侧周围组织的尺寸。
对于微螺纹、钛酸锶喷砂处理的种植体即刻加载/临时修复，预期结果是嵴顶骨的普遍维持以及种植体周围龈乳头软组织尺寸的增加。通过控制种植体周围组织，可以为使用牙种植体进行前牙修复提供可预测且美观的治疗效果。
