Prati Carlo, Zamparini Fausto, Scialabba Viviana Stella, Gatto Maria Rosaria, Piattelli Adriano, Montebugnoli Lucio, Gandolfi Maria Giovanna
Int J Oral Maxillofac Implants. 2016 Mar-Apr;31(2):413-23. doi: 10.11607/jomi.4623.
To evaluate the survival rate and marginal bone loss (MBL) of a calcium phosphate-blasted titanium implant inserted by a flap or flapless technique and to study the morphochemical characteristics of the implant surface.
Sixty out of 85 patients who received one or more implants were selected as eligible for this prospective longitudinal cohort clinical study. Titanium implants (n = 132) were placed in human healthy subjects using either a flap or flapless technique, selected on the basis of the best practice. The survival rate and MBL were evaluated after 3 months (preloading stress-free healing period) and after 6, 12, 24, and 36 months in relation to implant diameter, location, sex, and smoking habits. Surface morphochemical analyses were performed by environmental scanning electron microscopy connected with energy-dispersive x-ray (ESEM/EDX).
The overall survival rate was 97.72%. After 3 and 36 months, MBL was 0.36 ± 0.66 mm and 1.09 ± 1.10 mm for the flapless group and 0.29 ± 0.51 mm and 1.03 ± 0.92 mm for the flap group. MBL showed a statistically significant increase with time (P = .0001), and differences were found at all times since 6 months. No statistical differences between the flapless and flap groups and sex were observed at any time, while MBL was significantly higher in the maxillary versus mandibular location (6, 12, and 24 months) and in smokers versus nonsmokers (6 months). Higher MBL in both groups was found for a smaller diameter (3.5 mm) than larger diameter (4.1, 5 mm). The surface showed a Ti-Al-V alloy displaying a uniform nanotexture.
The implant system showed a high survival rate and markedly lower MBL considering the limits for acceptable progression. Flapless and flap techniques demonstrated similar results of MBL at the preloading healing period and at the 6 months to 3 years postloading periods. Both surgical procedures induced an early MBL during the preloading stress-free period. Implant diameter, mandibular/maxillary location, preloading stress-free period, and smoking habits affect MBL more than the type of surgery after both short- and long-term follow-up.
评估采用翻瓣或不翻瓣技术植入的磷酸钙喷砂处理钛种植体的存活率和边缘骨丢失（MBL）情况，并研究种植体表面的形态化学特征。
从85例接受一个或多个种植体的患者中选取60例符合本前瞻性纵向队列临床研究的条件。根据最佳实践选择钛种植体（n = 132），采用翻瓣或不翻瓣技术植入健康人体受试者体内。在3个月（预加载无应力愈合期）以及6、12、24和36个月后，根据种植体直径、位置、性别和吸烟习惯评估存活率和MBL。通过与能量色散X射线（ESEM/EDX）相连的环境扫描电子显微镜进行表面形态化学分析。
总体存活率为97.72%。3个月和36个月后，不翻瓣组的MBL分别为0.36±0.66毫米和1.09±1.10毫米，翻瓣组分别为0.29±0.51毫米和1.03±0.92毫米。MBL随时间有统计学显著增加（P = .0001），自6个月起各时间点均有差异。在任何时间，未观察到不翻瓣组与翻瓣组以及性别之间的统计学差异，而在上颌与下颌位置（6、12和24个月）以及吸烟者与非吸烟者（6个月）之间，MBL显著更高。两组中直径较小（3.5毫米）的种植体比直径较大（4.1、5毫米）的种植体MBL更高。表面显示为呈现均匀纳米纹理的Ti-Al-V合金。
考虑到可接受进展的限度，该种植体系统显示出高存活率和明显更低的MBL。不翻瓣和翻瓣技术在预加载愈合期以及加载后6个月至3年期间显示出相似MBL结果。两种手术操作在预加载无应力期均导致早期MBL。短期和长期随访后，种植体直径、下颌/上颌位置、预加载无应力期和吸烟习惯对MBL的影响大于手术类型。
