Vigolo Paolo, Mutinelli Sabrina, Zaccaria Massimiliano, Stellini Edoardo
Int J Oral Maxillofac Implants. 2015 Mar-Apr;30(2):411-8. doi: 10.11607/jomi.3837.
The management of occlusal forces on implant restorations may influence their long-term prosthetic success. The purpose of this randomized controlled trial was to compare marginal bone level changes around adjacent splinted and nonsplinted implants, functionally loaded with cemented restorations, up to 10 years in maxillae.
During 2002 and 2003, all patients who received three adjacent implants in a private office and a university setting were included in this study. All implants featured an external-hexagon design and were placed in the posterior maxilla. Implants in the left maxilla were randomly selected to be restored with splinted cemented restorations; maxillary right implants were restored with nonsplinted cemented restorations. Marginal bone resorption was measured with intraoral radiographs yearly over a period of at least 10 years after placement of abutments and restorations. The amount of bone loss in each group was analyzed with the two-sample Wilcoxon rank-sum (Mann-Whitney) test because variable bone loss was normally distributed at the fifth year only.
One hundred thirty-two implants were placed in 44 patients. Three implants failed at stage-two surgery. Five years after initial loading, two patients moved away and were lost to follow-up (6 implants in total); three additional patients did not complete the study (9 implants in total). Of the remaining 114 implants, 60 left implants were restored with splinted cemented restorations and 54 right implants were restored with nonsplinted cemented restorations. At 10 years, the splinted group showed a mean of 1.2 mm (interquartile range: 0.2 mm) of bone loss; the nonsplinted group showed 1.3 mm (interquartile range: 0.2 mm).
A significant difference in bone loss was seen between the two groups. However, the difference of 0.1 mm was not considered clinically meaningful.
种植体修复体上咬合力量的管理可能会影响其长期的修复成功。这项随机对照试验的目的是比较在上颌骨中，使用粘结修复体进行功能加载的相邻联冠式和非联冠式种植体周围边缘骨水平变化，观察长达10年的时间。
在2002年至2003年期间，所有在私人诊所和大学环境中接受了三个相邻种植体的患者都被纳入本研究。所有种植体均采用外六角设计，并植入上颌后部。随机选择左上颌的种植体用联冠式粘结修复体进行修复；右上颌的种植体用非联冠式粘结修复体进行修复。在基台和修复体植入后至少10年的时间里，每年通过口腔内X光片测量边缘骨吸收情况。由于变量骨丢失仅在第五年呈正态分布，因此使用两样本Wilcoxon秩和（Mann-Whitney）检验分析每组的骨丢失量。
44例患者共植入132枚种植体。3枚种植体在二期手术时失败。初始加载后5年，2例患者搬走并失访（共6枚种植体）；另外3例患者未完成研究（共9枚种植体）。在其余114枚种植体中，60枚左种植体用联冠式粘结修复体进行修复，54枚右种植体用非联冠式粘结修复体进行修复。10年后，联冠式组的骨丢失平均为1.2毫米（四分位间距：0.2毫米）；非联冠式组为1.3毫米（四分位间距：0.2毫米）。
两组之间在骨丢失方面存在显著差异。然而，0.1毫米的差异在临床上不被认为有意义。
