Linkevicius Tomas, Puisys Algirdas, Svediene Olga, Linkevicius Rokas, Linkeviciene Laura
Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania; Vilnius Research Group, Vilnius, Lithuania.
Clin Oral Implants Res. 2015 May;26(5):599-605. doi: 10.1111/clr.12544. Epub 2015 Jan 5.
To compare how laser-microtextured implants and implants with platform switching maintain crestal bone stability in thin peri-implant tissues.
Thirty laser-microtextured implants of 4.6 mm diameter (Tapered Internal Laser-Lok, BioHorizons, Birmingham, AL, USA; Group 1) and 30 implants with platform switching of 5/4 mm diameter (Certain Prevail; Biomet/3i, Palm Beach Gardens, FL, USA; Group 2) were placed in 30 patients (12 males and 18 females, mean age 42.3 ± 2.4) with thin mucosal tissues (≤2 mm). Implants were placed in posterior mandible in one-stage approach and after integration were restored with screw-retained metal-ceramic restorations. Radiographic examination was performed after implant placement, 2 months after healing, at prosthetic restoration delivery and after 1-year follow-up. Mean crestal bone loss was calculated, Mann-Whitney U-test was applied, and significance was set to 0.05.
After 2 months of healing, the crestal bone loss was 0.71 ± 0.25 mm SD (range, 0.25-1.6 mm) and 1.02 ± 0.25 mm SD (range, 0.6-1.55 mm) in groups 1 and 2, respectively (P = 0.001). At restorations' delivery, the crestal bone loss was 1.10 ± 0.30 mm SD (range, 0.65-1.85 mm) and 1.37 ± 0.27 mm SD (range, 0.90-1.80 mm) in groups 1 and 2, respectively (P = 0.001). After 1-year follow-up, the crestal bone loss was 1.41 ± 0.42 mm SD (range, +0.1-2.30 mm) and 1.43 ± 0.23 mm SD (range, 1-1.80 mm) in groups 1 and 2, respectively (P = 0.976).
Laser-microtexturing of implant collar or platform-switched implant/abutment connection did not eliminate crestal bone loss, if at the time of implant placement vertical soft tissue thickness was ≤2 mm. However, laser-microtextured implants may present less proximal bone loss than platform-switching implants in the period before implant loading.
比较激光微纹理种植体和采用平台转换的种植体在薄种植体周围组织中维持牙槽嵴骨稳定性的情况。
将30枚直径4.6 mm的激光微纹理种植体(锥形内连接激光锁定种植体,美国阿拉巴马州伯明翰市BioHorizons公司;第1组)和30枚直径5/4 mm的采用平台转换的种植体(Certain Prevail;美国佛罗里达州棕榈滩花园市Biomet/3i公司;第2组)植入30例患者(12例男性和18例女性,平均年龄42.3±2.4岁)的薄黏膜组织(≤2 mm)中。种植体通过一期手术植入下颌后牙区,愈合后用螺丝固位的金属烤瓷修复体进行修复。在种植体植入后、愈合2个月后、修复体戴入时以及1年随访后进行影像学检查。计算平均牙槽嵴骨吸收量,应用曼-惠特尼U检验,显著性水平设定为0.05。
愈合2个月后,第1组和第2组的牙槽嵴骨吸收量分别为0.71±0.25 mm标准差(范围0.25 - 1.6 mm)和1.02±0.25 mm标准差(范围0.6 - 1.55 mm)(P = 0.001)。在修复体戴入时,第1组和第2组的牙槽嵴骨吸收量分别为1.10±0.30 mm标准差(范围0.65 - 1.85 mm)和1.37±0.27 mm标准差(范围0.90 - 1.80 mm)(P = 0.001)。1年随访后,第1组和第2组的牙槽嵴骨吸收量分别为1.41±0.42 mm标准差(范围 +0.1 - 2.30 mm)和1.43±0.23 mm标准差(范围1 - 1.80 mm)(P = 0.976)。
如果种植体植入时垂直软组织厚度≤2 mm,种植体颈部的激光微纹理或平台转换种植体/基台连接并不能消除牙槽嵴骨吸收。然而,在种植体加载前的阶段,激光微纹理种植体可能比平台转换种植体出现更少的近中骨吸收。