定制氧化锆和钛种植体基台用于犬齿和后牙区单颗种植体的随机对照临床试验：3年结果
Randomized-controlled clinical trial of customized zirconia and titanium implant abutments for single-tooth implants in canine and posterior regions: 3-year results.
作者信息
Zembic Anja, Sailer Irena, Jung Ronald Ernst, Hämmerle Christoph Hans Franz
机构信息
Department of Fixed and Removable Prosthodontics and Dental Material Science, Center for Dental and Oral Medicine, University of Zurich, Zurich, Switzerland.
出版信息
Clin Oral Implants Res. 2009 Aug;20(8):802-8. doi: 10.1111/j.1600-0501.2009.01717.x. Epub 2009 May 26.
OBJECTIVES
The aim was to test whether or not zirconia abutments exhibit the same survival and technical/biological outcome as titanium abutments.
MATERIAL AND METHODS
Twenty-two patients receiving 40 single-tooth implants in canine and posterior regions were included. The implant sites were randomly assigned to 20 zirconia and 20 titanium abutments. All-ceramic and metal-ceramic crowns were fabricated. At baseline, 6, 12 and 36 months, the reconstructions were examined for technical and biological problems. Probing pocket depth (PPD), plaque control record (PCR) and bleeding on probing (BOP) were assessed at abutments (test) and analogous contralateral teeth (control). Standardized radiographs of the implants were made and the bone level (BL) was measured referring to the implant shoulder on mesial (mBL) and distal sides (dBL). The difference of color (DeltaE) of the peri-implant mucosa and the gingiva of control teeth was assessed with a spectrophotometer. The data were statistically analyzed with Mann-Whitney Rank and Student's unpaired t-tests.
RESULTS
Eighteen patients with 18 zirconia and 10 titanium abutments were examined at a mean follow-up of 36 months (range 31.5-53.3 months). No fracture of an abutment or loss of a reconstruction was found. Hence, both exhibited 100% survival. At two metal-ceramic crowns supported by titanium abutments chipping of the veneering ceramic occurred. No difference of the biological outcome of zirconia and titanium abutments was observed: PPD (meanPPD(ZrO(2)) 3.2 +/- 1 mm, mPPD(Ti) 3.4 +/- 0.5 mm), PCR (mPCR(ZrO(2)) 0.1 +/- 0.2, mPCR(Ti) 0.1 +/- 0.2) and BOP (mBOP(ZrO(2)) 0.4 +/- 0.4, mBOP(Ti) 0.2 +/- 0.3). Furthermore, the BL was similar at implants supporting zirconia and titanium abutments (mBL(ZrO(2)) 1.7 +/- 1, dBL(ZrO(2)) 1.6 +/- 1; mBL(Ti) 2 +/- 1, dBL(Ti) 2.1 +/- 1). Both, zirconia and titanium abutments induced a similar amount of discoloration of the mucosa compared with the gingiva at natural teeth (DeltaE(ZrO(2)) 9.3 +/- 3.8, DeltaE(Ti) 6.8 +/- 3.8).
CONCLUSIONS
At 3 years, zirconia and titanium abutments exhibited same survival and technical, biological and esthetical outcomes.
目的
旨在测试氧化锆基台与钛基台在生存率以及技术/生物学结果方面是否相同。
材料与方法
纳入22例在犬齿和后牙区域接受40颗单颗牙种植的患者。将种植部位随机分配至20个氧化锆基台和20个钛基台。制作全瓷和金属烤瓷冠。在基线、6个月、12个月和36个月时，检查修复体的技术和生物学问题。在基台（测试）和对侧同名牙（对照）处评估探诊深度（PPD）、菌斑控制记录（PCR）和探诊出血（BOP）。拍摄种植体的标准化X线片，并参照种植体肩部在近中（mBL）和远中侧（dBL）测量骨水平（BL）。用分光光度计评估种植体周围黏膜与对照牙牙龈的颜色差异（DeltaE）。数据采用曼-惠特尼秩和检验与学生氏非配对t检验进行统计学分析。
结果
对18例患者（18个氧化锆基台和10个钛基台）进行了平均36个月（范围31.5 - 53.3个月）的随访检查。未发现基台骨折或修复体脱落。因此，两者的生存率均为100%。在两颗由钛基台支持的金属烤瓷冠上出现了饰面陶瓷崩瓷的情况。未观察到氧化锆基台和钛基台在生物学结果上存在差异：PPD（氧化锆平均PPD(ZrO₂) 3.2 ± 1mm，钛平均PPD(Ti) 3.4 ± 0.5mm）、PCR（氧化锆平均PCR(ZrO₂) 0.1 ± 0.2，钛平均PCR(Ti) 0.1 ± 0.2）和BOP（氧化锆平均BOP(ZrO₂) 0.4 ± 0.4，钛平均BOP(Ti) 0.2 ± 0.3）。此外，支持氧化锆和钛基台的种植体的骨水平相似（氧化锆近中骨水平mBL(ZrO₂) 1.7 ± 1，远中骨水平dBL(ZrO₂) 1.6 ± 1；钛近中骨水平mBL(Ti) 2 ± 一、远中骨水平dBL(Ti) 2.1 ± 1）。与天然牙牙龈相比，氧化锆和钛基台导致的黏膜变色量相似（氧化锆DeltaE(ZrO₂) 9.3 ± 3.8，钛DeltaE(Ti) 6.8 ± 3.8）。
结论
3年后，氧化锆基台和钛基台在生存率以及技术、生物学和美学结果方面表现相同。
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