Happe Arndt, Schulte-Mattler Verena, Fickl Stefan, Naumann Michael, Zöller Joachim E, Rothamel Daniel
Department of Oral and Maxillofacial Plastic Surgery, University of Cologne, Germany.
Clin Oral Implants Res. 2013 Aug;24 Suppl A100:28-33. doi: 10.1111/j.1600-0501.2011.02361.x. Epub 2011 Dec 6.
The purpose of this study was to investigate the optical appearance of the soft tissue labial to dental implants restored with fluorescent ceramic-veneered zircona abutments. It was hypothesized that the tested abutment design leads to an increased brightness in the marginal peri-implant tissue, which does not differ from that of natural teeth. Moreover, a reduction of the color difference that has been reported from other abutment materials was expected.
A total of 12 patients with single titanium implants in the maxillary anterior region were recruited. All implants (N = 12) were restored with zirconia abutments veneered with fluorescent ceramic and full-ceramic crowns. Color measurements of the peri-implant mucosa at the test sites were made of the facial aspect of the teeth using a Spectroshade-spectrophotometer. The gingiva of a contralateral or adjacent natural tooth served as a control. Color data (CIE-Lab* color coordinates) were obtained in five incremental areas of 1 × 2 mm in both test and control sites. ∆E-values were calculated from the ΔL*, Δa* and Δb* values for each patient.
Data acquisition from the test site demonstrated lower mean values of L*, a* and b* than the control site. Statistical significance between the test site and control site was reached in the L* values only in the second of the five incremental areas (P < 0.05, Wilcoxon test). However, discrepancies in a*- and b*-values reached a statistically significant difference in the incremental areas 1, 2 and 4, and in b* in area 5 (P < 0.05, Wilcoxon test). Medians of the ∆E-values in all five increments were found to be higher than the clinical perceptual threshold of 3.7. However, considering the original data, five individual patients did not reach the threshold in increment 1 and 2, two in increment 3 and three in increment 4. None of the patients showed lower ∆E-values than the perceptual threshold of 3.7 in increment 5, which had the largest distance from the gingival margin.
The tested abutment design leads to a peri-implant soft tissue color that, in the critical marginal area, in five of 12 patients did not statistically differ from the tissue of the gingiva of natural teeth. Particularly, the brightness of the peri-implant soft-tissue seemed to be more adapted to the natural situation using a fluorescent abutment design.
本研究旨在调查使用荧光陶瓷贴面氧化锆基台修复的牙种植体唇侧软组织的光学外观。研究假设为，所测试的基台设计会使种植体周围边缘组织的亮度增加，且与天然牙的亮度无差异。此外，预计与其他基台材料相比，颜色差异会减小。
招募了12名上颌前部区域有单个钛种植体的患者。所有种植体（N = 12）均用荧光陶瓷贴面氧化锆基台和全瓷冠进行修复。使用Spectroshade分光光度计对测试部位种植体周围黏膜的牙齿面部进行颜色测量。以对侧或相邻天然牙的牙龈作为对照。在测试部位和对照部位的五个1×2mm的递增区域获取颜色数据（CIE-Lab颜色坐标）。根据每位患者的ΔL、Δa和Δb值计算ΔE值。
测试部位的数据采集显示L*、a和b的平均值低于对照部位。仅在五个递增区域中的第二个区域，测试部位和对照部位的L值达到统计学显著性（P < 0.05，Wilcoxon检验）。然而，在递增区域1、2和4中，a值和b值的差异达到统计学显著性，在区域5中b值差异达到统计学显著性（P < 0.05，Wilcoxon检验）。所有五个递增区域的ΔE值中位数均高于临床感知阈值3.7。然而，考虑原始数据，五名个体患者在递增区域1和2未达到阈值，两名在递增区域3未达到，三名在递增区域4未达到。在距牙龈边缘距离最大的递增区域5中，没有患者的ΔE值低于感知阈值3.7。
所测试的基台设计导致种植体周围软组织颜色在关键边缘区域，12名患者中有5名在统计学上与天然牙牙龈组织无差异。特别是，使用荧光基台设计时，种植体周围软组织的亮度似乎更接近自然状态。
