Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Patumwan, Bangkok, Thailand.
Clin Oral Implants Res. 2010 Jun;21(6):662-70. doi: 10.1111/j.1600-0501.2009.01887.x. Epub 2010 Apr 5.
Peri-implant soft tissue recession is a major esthetic concern for the anterior implants. The aim of this study was to determine the factors that affected the facial marginal mucosal level and papilla level around single-tooth implants in the anterior maxilla.
Forty single-tooth implants in the anterior maxilla were studied. Variables possibly associated with the soft tissue level were obtained from clinical measurements, study models, peri-apical radiographs, and computerized tomograms. Fisher's exact test, analysis of variance, and binary logistic regression analysis were used to determine the influence of each factor on the facial marginal mucosal level and papilla level.
The majority of the implants (75%) replaced the upper central incisors. The facial mucosal margin of the implant was 0.5+/-0.9 mm more apical than that of the contralateral tooth. Half or more of papilla fill was observed in 89% of the samples. More apical level of the facial mucosal margin at the implant sites was significantly influenced by many factors including a thin peri-implant biotype, a proclined implant fixture angle, more apical level of the facial bone crest, increased distance from the contact point to the bone crest, contact point to the platform, and contact point to implant bone. A thin biotype was the most significant factor in determining the facial marginal mucosal level. Increased distance from the contact point to the bone crest was the only factor significantly associated with less papilla fill.
The papilla level around single-tooth implants in the anterior maxilla was mainly influenced by the interproximal bone crest level of the adjacent tooth. Facial marginal mucosal level, on the other hand, was affected by multiple factors including the peri-implant biotype, the facial bone crest level, the implant fixture angle, the interproximal bone crest level, the depth of implant platform, and the level of first bone to implant contact.
种植体周围软组织退缩是前牙种植体的主要美学关注点。本研究旨在确定影响上前牙单颗种植体唇侧边缘黏膜水平和龈乳头水平的因素。
研究了上前牙的 40 颗单颗种植体。从临床测量、研究模型、根尖片和计算机断层扫描中获取可能与软组织水平相关的变量。采用 Fisher 确切检验、方差分析和二项逻辑回归分析来确定每个因素对唇侧边缘黏膜水平和龈乳头水平的影响。
大多数种植体（75%）取代了上颌中切牙。种植体唇侧黏膜边缘比对侧同名牙向根尖方向退缩 0.5+/-0.9mm。89%的样本中观察到龈乳头填充了一半或更多。种植体唇侧边缘的更根尖位置受许多因素显著影响，包括种植体周围组织薄型、种植体倾斜角度、唇侧骨嵴更高的位置、从接触点到骨嵴的距离增加、从接触点到平台的距离和从接触点到种植体骨的距离。薄型种植体周围组织是决定唇侧边缘黏膜水平的最重要因素。从接触点到骨嵴的距离增加是唯一与龈乳头填充不足显著相关的因素。
上前牙单颗种植体周围龈乳头水平主要受邻牙近中骨嵴水平的影响。另一方面，唇侧边缘黏膜水平受多种因素影响，包括种植体周围组织类型、唇侧骨嵴水平、种植体倾斜角度、邻牙近中骨嵴水平、种植体平台深度和第一骨与种植体接触水平。
