Gallucci German O, Mavropoulos Anestis, Bernard Jean-Pierre, Belser Urs C
Department of Restorative Dentistry and Biomaterials Science, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA.
Int J Oral Maxillofac Implants. 2007 Jul-Aug;22(4):595-602.
This study investigates the pre- and posttreatment morphology of the mucosa around immediately loaded implants in the edentulous maxilla.
Implants were placed and immediately loaded in edentulous maxillae; pre- and posttreatment impressions were obtained. The resulting casts were digitalized into 3-dimensional images, and the pre- and posttreatment images were superimposed. The width and height of the maxillary alveolar process were measured at central and interproximal implant sites in a vertical section of the superimposed holograms. For statistical analysis, the Delta value (d) was defined as the difference between the pre- and posttreatment images for all measurements.
Sixty-seven Straumann implants placed in 9 patients and immediately restored with provisional fixed restorations were analyzed. An increase in width at all measurement sites was observed after treatment. Width increased for both central implant (1.51 +/- 1.16 mm, P < .001) and interproximal implant sections (1.02 +/- 1.21 mm, P < .001). Mean d for height was found to be decreased at central implant sites (-1.21 +/- 1.67 mm, P = .012) and at interproximal sections (-0.72 +/- 1.68 mm, P = .098).
Clinically, it has been observed that the placement of an immediate provisional affects the peri-implant tissue morphology according to its emergence profile. The result after treatment was a wider contour of the peri-implant soft tissue, located in a more apical position than the original mucosal level. The most coronal part of the papilla-like mucosa at interproximal sites would be nearest to the original mucosal level before treatment. The scalloped mucosal configuration obtained was consistent along the rehabilitated arch. Statistically significant dimensional changes of the peri-implant mucosa were observed with an immediate loading approach.
本研究调查无牙上颌即刻负重种植体周围黏膜治疗前和治疗后的形态。
在上颌无牙区植入种植体并即刻负重；获取治疗前和治疗后的印模。将所得模型数字化为三维图像，并将治疗前和治疗后的图像叠加。在叠加全息图的垂直截面中，于种植体中央及邻间隙部位测量上颌牙槽突的宽度和高度。为进行统计分析，将所有测量的Delta值（d）定义为治疗前和治疗后图像之间的差值。
分析了9例患者植入的67枚士卓曼种植体，这些种植体即刻用临时固定修复体修复。治疗后所有测量部位的宽度均增加。种植体中央部位宽度增加（1.51±1.16mm，P <.001），种植体邻间隙部位宽度增加（1.02±1.21mm，P <.001）。发现种植体中央部位高度的平均d值降低（-1.21±1.67mm，P =.012），邻间隙部位高度的平均d值降低（-0.72±1.68mm，P =.098）。
临床上观察到，即刻临时修复体的放置会根据其龈缘外形影响种植体周围组织形态。治疗后的结果是种植体周围软组织轮廓变宽，位于比原始黏膜水平更根尖的位置。邻间隙部位乳头样黏膜最冠方部分最接近治疗前的原始黏膜水平。在修复牙弓上获得的扇贝状黏膜形态是一致的。采用即刻负重方法观察到种植体周围黏膜有统计学意义的尺寸变化。
