Korsch Michael, Walther Winfried
Dental Academy for Continuing Professional Development, Karlsruhe, Germany.
Clin Implant Dent Relat Res. 2015 Oct;17 Suppl 2:e434-43. doi: 10.1111/cid.12265. Epub 2014 Sep 2.
The cementation of fixed implant-supported dental restorations involves the risk of leaving excess cement in the mouth which can promote biofilm formation in the peri-implant sulcus. As a result, an inflammation may develop.
The aim of the present study was to investigate the clinical effect of two different luting cements on the peri-implant tissue.
Within the scope of a retrospective clinical follow-up study, the prosthetic structures of 22 patients with 45 implants were revised. In all cases, a methacrylate cement (Premier Implant Cement [PIC], Premier® Dental Products Company, Plymouth Meeting, PA, USA) had been used for cementation. In 16 additional patients with 28 implants, the suprastructures were retained with a zinc oxide-eugenol cement (Temp Bond [TB], Kerr Sybron Dental Specialities, Glendora, CA, USA). These patients were evaluated in the course of routine treatment.
In both populations, the retention time of the suprastructures was similar (TB 3.77 years, PIC 4.07 years). In the PIC cases, 62% of all implants had excess cement. In the TB cases, excess cement was not detectable on any of the implants. Bleeding on probing was significantly more frequent on implants cemented with PIC (100% with and 94% without excess cement) than on implants cemented with TB (46%). Pocket suppuration was observed on 89% of the PIC-cemented implants with excess cement (PIC without excess cement 24%), whereas implants with TB were not affected by it at all. The peri-implant bone loss was significantly greater in the PIC patients (with excess cement 1.37 mm, without excess cement 0.41 mm) than it was in the TB patients (0.07 mm).
The frequency of undetected excess cement depends essentially on the type of cement used. Cements that tend to leave more undetected excess have a higher prevalence for peri-implant inflammation and cause a more severe peri-implant bone loss.
固定种植体支持式牙修复体的黏固存在在口腔内残留多余黏固剂的风险,这会促进种植体周围龈沟内生物膜的形成。结果可能会引发炎症。
本研究的目的是调查两种不同黏固水门汀对种植体周围组织的临床效果。
在一项回顾性临床随访研究范围内,对22例患者的45颗种植体的修复结构进行了翻修。所有病例均使用甲基丙烯酸酯黏固剂(美国宾夕法尼亚州普利茅斯会议市普利茅斯牙科产品公司的Premier种植体黏固剂[PIC])进行黏固。另外16例患者的28颗种植体,其上部结构用氧化锌丁香酚黏固剂(美国加利福尼亚州格伦多拉市克尔西布朗牙科专业公司的Temp Bond[TB])保留。这些患者在常规治疗过程中接受评估。
在这两组人群中,上部结构的保留时间相似(TB组为3.77年,PIC组为4.07年)。在使用PIC的病例中,所有种植体中有62%存在多余黏固剂。在使用TB的病例中,任何种植体上均未检测到多余黏固剂。使用PIC黏固的种植体探诊出血明显比使用TB黏固的种植体更频繁(有多余黏固剂的为100%,无多余黏固剂的为94%,而使用TB的为46%)。在89%有多余黏固剂的PIC黏固种植体上观察到袋内化脓(无多余黏固剂的PIC种植体为24%),而使用TB的种植体完全未受影响。PIC组患者的种植体周围骨吸收明显大于TB组患者(有多余黏固剂的为1.37毫米,无多余黏固剂的为0.41毫米,而TB组为0.07毫米)。
未检测到的多余黏固剂的频率主要取决于所用黏固剂的类型。容易残留更多未检测到的多余黏固剂的黏固剂,种植体周围炎症的发生率更高,并导致更严重的种植体周围骨吸收。