比较两种牙种植体类型的前瞻性随机对照临床研究：加载1年后的软组织体积变化
Prospective randomized controlled clinical study comparing two dental implant types: volumetric soft tissue changes at 1 year of loading.
作者信息
Sanz Martin Ignacio, Benic Goran I, Hämmerle Christoph H F, Thoma Daniel S
机构信息
Section of Periodontology, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain.
Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
出版信息
Clin Oral Implants Res. 2016 Apr;27(4):406-11. doi: 10.1111/clr.12579. Epub 2015 Feb 26.
OBJECTIVE
To evaluate the volumetric changes occurring from prosthesis insertion to the 1-year follow-up (FU) using one- and two-piece dental implants.
METHODS
Sixty patients were randomly assigned to receive one-piece or two-piece implants. Casts were obtained at baseline (insertion of final reconstruction) and at 1 year of loading. Finally, 33 pairs of casts (BRA = 18, STM = 15) were deemed appropriate for volumetric analysis of the peri-implant tissues. If the patients had more than one implant, one was randomly selected for analysis. Casts were scanned to obtain stereolithography (STL) files. Baseline and 1-year FU digital models were superimposed with an image analysis program. Linear and volumetric measurements were performed including (i) crown height changes (CHCs), (ii) volumetric changes, and (iii) changes in tissue thickness at three levels below the mucosal margin on the buccal side of the implants (at 1,3, and 5 mm). The Mann-Whitney U-test and the paired t-test were used to analyze the data between the two groups using the patient as the unit of analysis.
RESULTS
No significant baseline differences were observed between the one- and two-piece groups for the linear measurements. The mean CHCs in the two-piece group amounted to 0.02 mm (SD ± 0.32), whereas the one-piece group exhibited a change of -0.17 mm (±0.57). The mean volume changes (VCs) were -0.12 mm (±0.27) (two-piece group) and -0.03 mm (±0.29) (one-piece group). With regard to the changes in tissue thickness, the two-piece group presented a change of -0.15 mm (±0.20) at 1 mm, -0.06 mm (±0.20) at 3 mm, and -0.2 mm (±0.51) at 5 mm. The respective values for the one-piece group were -0.03 mm (±0.35), 0.01 mm (±0.28), and -0.01 mm (±0.51) at the three levels. None of the differences in linear measurements between baseline and the 1-year FU reached significance. Positive correlations were seen for tissue thickness changes at 1 and 3 mm for both groups (P < 0.05). Significant positive correlations were found for VCs and tissue thickness at 1 mm for the two-piece group and for VCs and tissue thickness at 1,3, and 5 mm for the one-piece group (P < 0.05).
CONCLUSION
Within the first year of loading, minimal changes occur with regard to tissue thickness, crown height, and facial volume for both implant types.
目的
使用一体式和两件式牙种植体评估从种植体植入到1年随访期间发生的体积变化。
方法
60名患者被随机分配接受一体式或两件式种植体。在基线（最终修复体植入）和加载1年后获取模型。最后，33对模型（BRA = 18，STM = 15）被认为适合对种植体周围组织进行体积分析。如果患者有多个种植体，则随机选择一个进行分析。对模型进行扫描以获得立体光刻（STL）文件。使用图像分析程序将基线和1年随访的数字模型进行叠加。进行线性和体积测量，包括（i）冠高度变化（CHC），（ii）体积变化，以及（iii）种植体颊侧黏膜边缘以下三个水平（1、3和5 mm）处组织厚度的变化。以患者为分析单位，使用Mann-Whitney U检验和配对t检验分析两组之间的数据。
结果
对于线性测量，一体式和两件式组在基线时未观察到显著差异。两件式组的平均CHC为0.02 mm（标准差±0.32），而一体式组的变化为 -0.17 mm（±0.57）。平均体积变化（VC）分别为 -0.12 mm（±0.27）（两件式组）和 -0.03 mm（±0.29）（一体式组）。关于组织厚度的变化，两件式组在1 mm处变化为 -0.15 mm（±0.20），在3 mm处为 -0.06 mm（±0.20），在5 mm处为 -0.2 mm（±0.51）。一体式组在三个水平处的相应值分别为 -0.03 mm（±0.35）、0.01 mm（±0.28）和 -0.01 mm（±0.51）。基线和1年随访之间的线性测量差异均未达到显著水平。两组在1和3 mm处的组织厚度变化均呈正相关（P < 0.05）。两件式组在1 mm处的VC与组织厚度呈显著正相关，一体式组在1、3和5 mm处的VC与组织厚度呈显著正相关（P < 0.05）。
结论
在加载的第一年内，两种种植体类型在组织厚度、冠高度和面部体积方面的变化都很小。
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