Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida 32610, USA.
Int J Oral Maxillofac Implants. 2013 May-Jun;28(3):807-14. doi: 10.11607/jomi.3022.
It has been reported that multiple abutment disconnections and reconnections following implant placement may compromise the peri-implant mucosal seal and may lead to increased marginal bone loss. Thus, the aim of this study was to evaluate the effect of healing abutment disconnection and reconnection on soft and hard peri-implant tissues.
Sixteen patients were included in this prospective randomized controlled clinical trial. Following one-stage implant placement, test group implants (n = 10) received a permanent abutment and control group implants (n = 11) received a healing abutment. After 2 months of healing, control group implants underwent a prosthetic protocol involving implant-level impressions and a two-time abutment disconnection and reconnection process prior to delivery of the definitive prosthesis. Test group implants underwent a prosthetic protocol involving abutment-level impressions without any abutment disconnection. Clinical parameters were recorded at 2 weeks, 2 months, 3 months, and 6 months, and marginal bone levels were assessed radiographically at implant placement, 3 months, and 6 months.
The overall survival rate from implant placement to the last follow-up visit was 100% for both groups. The mean marginal bone loss at the 6-month examination was 0.13 mm for test group implants and 0.28 mm for control group implants. There were no significant differences regarding changes in peri-implant mucosal dimensions between the two groups.
The present study indicates that implants receiving a final abutment at the time of implant placement exhibited minimal marginal bone loss and were similar to implants subjected to abutment disconnection and reconnection two times. Disconnection and reconnection of the abutment two times did not cause negative dimensional changes in the peri-implant mucosa.
据报道，种植体放置后多次进行基台连接和断开可能会破坏种植体周围黏膜密封，并导致边缘骨吸收增加。因此，本研究旨在评估愈合基台连接和断开对种植体软硬组织的影响。
本前瞻性随机对照临床试验纳入了 16 名患者。一期种植体植入后，实验组（n=10）植入体采用永久基台，对照组（n=11）植入体采用愈合基台。愈合 2 个月后，对照组植入体进行了修复方案，包括种植体水平印模和两次基台连接和断开过程，然后再交付最终修复体。实验组植入体进行了修复方案，包括基台水平印模，而没有进行任何基台断开。在 2 周、2 个月、3 个月和 6 个月时记录临床参数，并在种植体植入、3 个月和 6 个月时进行放射学评估边缘骨水平。
两组从种植体植入到最后随访的总体存活率均为 100%。实验组在 6 个月检查时的平均边缘骨吸收量为 0.13 毫米，对照组为 0.28 毫米。两组之间的种植体周围黏膜尺寸变化没有显著差异。
本研究表明，种植体植入时立即使用最终基台的种植体表现出最小的边缘骨吸收，与接受两次基台连接和断开的种植体相似。基台两次连接和断开不会导致种植体周围黏膜的负向尺寸变化。
