Cochran David L, Bosshardt Dieter D, Grize Leticia, Higginbottom Frank L, Jones Archie A, Jung Ronald E, Wieland Marco, Dard Michel
Department of Periodontics, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, USA.
J Periodontol. 2009 Apr;80(4):609-17. doi: 10.1902/jop.2009.080323.
One way to evaluate various implant restorations is to measure the amount of bone change that occurs at the crestal bone. The objective of this study was to histologically evaluate the alveolar bone change around a bone-level, non-matching implant-abutment diameter configuration that incorporated a horizontal offset and a Morse taper internal connection.
The study design included extraction of all mandibular premolars and first molars in five canines. After 3 months, 12 dental implants were placed at three levels in each dog: even with the alveolar crest, 1 mm above the alveolar crest, and 1 mm below the alveolar crest. The implants were submerged on one side of the mandible. On the other side, healing abutments were exposed to the oral cavity (non-submerged). Gold crowns were attached 2 months after implant placement. The dogs were sacrificed 6 months postloading, and specimens were processed for histologic and histometric analyses.
Evaluation of the specimens indicated that the marginal bone remained near the top of the implants under submerged and non-submerged conditions. The amount of bone change for submerged implants placed even with, 1 mm below, and 1 mm above the alveolar crest was -0.34, -1.29, and 0.04 mm, respectively (negative values indicate bone loss). For non-submerged implants, the respective values were -0.38, -1.13, and 0.19 mm. For submerged and non-submerged implants, there were significant differences in the amount of bone change among the three groups (P <0.05). The percentage of bone-to-implant contact for submerged implants was 73.3%, 71.8%, and 71.5%. For non-submerged implants, the respective numbers were 73.2%, 74.5%, and 76%. No significant differences occurred with regard to the percentage of bone contact.
Minimal histologic bone loss occurred when dental implants with non-matching implant-abutment diameters were placed at the bone crest and were loaded for 6 months in the canine. The bone loss was significantly less (five- to six-fold) than that reported for bone-level implants with matching implant-abutment diameters (butt-joint connections).
评估各种种植体修复体的一种方法是测量牙槽嵴顶处发生的骨变化量。本研究的目的是从组织学角度评估一种骨水平、种植体与基台直径不匹配的结构周围的牙槽骨变化,该结构包含水平偏移和莫氏锥度内部连接。
研究设计包括拔除五只犬的所有下颌前磨牙和第一磨牙。3个月后,在每只犬的三个水平位置植入12颗牙种植体:与牙槽嵴平齐、牙槽嵴上方1mm和牙槽嵴下方1mm。种植体在下颌骨的一侧进行埋植。在另一侧,愈合基台暴露于口腔(非埋植)。种植体植入2个月后安装金冠。加载6个月后处死犬,对标本进行组织学和组织计量学分析。
对标本的评估表明,在埋植和非埋植条件下,边缘骨仍靠近种植体顶部。与牙槽嵴平齐、牙槽嵴下方1mm和牙槽嵴上方1mm处埋植的种植体的骨变化量分别为-0.34、-1.29和0.04mm(负值表示骨吸收)。对于非埋植种植体,相应的值分别为-0.38、-1.13和0.19mm。对于埋植和非埋植种植体,三组之间的骨变化量存在显著差异(P<0.05)。埋植种植体的骨与种植体接触百分比分别为73.3%、71.8%和71.5%。对于非埋植种植体,相应的数值分别为73.2%、74.5%和76%。骨接触百分比方面未出现显著差异。
当种植体与基台直径不匹配的牙种植体放置在牙槽嵴处并在犬体内加载6个月时,组织学上的骨吸收极少。骨吸收明显少于(五到六倍)报道的种植体与基台直径匹配(对接连接)骨水平种植体的骨吸收。