Siadat Hakimeh, Panjnoosh Mehrdad, Alikhasi Marzieh, Alihoseini Masoud, Bassir Seyed Hossein, Rokn Amir Reza
Implant Research Center and Department of Prosthodontics, Tehran University of Medical Sciences School of Dentistry, Tehran, Iran.
J Oral Maxillofac Surg. 2012 Feb;70(2):307-13. doi: 10.1016/j.joms.2011.09.006. Epub 2011 Dec 14.
The purpose of the present study was to compare the crestal bone loss around implants placed according to either a 1-stage or 2-stage implant installation procedure using a digital subtraction radiography technique.
In the present randomized clinical trial, screw-shaped tapered implants were inserted in the posterior mandible of patients needing fixed partial dentures. In each edentulous area, according to the randomization table, 1 implant was inserted using a 1-stage procedure (group 1) and 1 was placed using a 2-stage approach (group 2). The implants were temporized with the relined denture after 2 weeks. All implants were functionally loaded with fixed partial dentures after 3 months. Crestal bone loss (primary outcome variable) was measured using a digital subtraction radiography technique. Standardized radiovisiographs were taken after implant insertion, after fixed partial denture installation (3 months after surgery), and after 6 and 12 months of functional loading. The data were analyzed using the Wilcoxon signed ranks test (α = 0.05).
Eleven patients (mean age 46.9 years, 3 women and 8 men) were included in the study. A total of 34 implants were inserted, 17 using a 1-stage protocol and 17 using a 2-stage protocol. Three months after implant placement, the 2-stage implants showed significantly more crestal bone loss (0.65 ± 0.71 mm) than the 1-stage implants (0.41 ± 0.53 mm; P = .02). However, after 6 and 12 months of functional loading, both groups showed comparable changes in bone level (P > .05).
No differences were found between 1-stage and 2-stage implant placement in crestal bone loss after 1 year of functional loading.
本研究旨在使用数字减影放射成像技术比较按照一期或二期种植体植入程序植入的种植体周围的牙槽嵴骨吸收情况。
在本随机临床试验中，将螺旋形锥形种植体植入需要固定局部义齿的患者下颌后部。在每个无牙区，根据随机表，使用一期程序植入1枚种植体（第1组），使用二期方法植入1枚种植体（第2组）。2周后用重衬义齿暂时修复种植体。3个月后所有种植体均用固定局部义齿进行功能加载。使用数字减影放射成像技术测量牙槽嵴骨吸收（主要观察变量）。在种植体植入后、固定局部义齿安装后（手术后3个月）以及功能加载6个月和12个月后拍摄标准化的口腔全景X线片。使用Wilcoxon符号秩检验分析数据（α = 0.05）。
11名患者（平均年龄46.9岁，3名女性和8名男性）纳入本研究。共植入34枚种植体，17枚采用一期方案，17枚采用二期方案。种植体植入3个月后，二期种植体的牙槽嵴骨吸收（0.65±0.71 mm）明显多于一期种植体（0.41±0.53 mm；P = 0.02）。然而，在功能加载6个月和12个月后，两组的骨水平变化相当（P>0.05）。
在功能加载1年后，一期和二期种植体植入在牙槽嵴骨吸收方面未发现差异。
