Pessoa Roberto S, Sousa Ravel M, Pereira Leandro M, Neves Flavio D, Bezerra Fabio J B, Jaecques Siegfried V N, Sloten Jos V, Quirynen Marc, Teughels Wim, Spin-Neto Rubens
CPBio - Research Center for Biomechanics, Biomaterials and Cell Biology, School of Dentistry, Federal University of Uberlandia, Uberlandia, Brazil.
Biomechanical Section, Catholic University of Leuven, Leuven, Belgium.
Clin Implant Dent Relat Res. 2017 Feb;19(1):97-110. doi: 10.1111/cid.12437. Epub 2016 Jun 29.
To evaluate clinical, radiographic, microbiologic, and biomechanical parameters related to bone remodeling around implants with external hexagon (EH) and Morse-taper (MT) connections.
Twelve totally edentulous patients received four custom-made implants in the interforaminal region of the mandible. Two of those implants had the same macroscopic design, but different prosthetic connections. All patients received an immediate implant-supported prosthesis. Clinical parameters (periimplant probing pocket depth (PPD), modified gingival index (mGI), and mucosal thickness (MTh)) were evaluated at 12 months follow-up. The distance between the top of the implant and the first bone-to-implant contact (IT-FBIC) was evaluated on standardized digital peri-apical radiographs acquired at 1, 3, 6, and 12 months follow-up. Samples of the subgingival microbiota were collected 1, 3, and 6 months after implant loading and used for the quantification of Tanerella forsythia, Porphyromonas gingivalis, Aggragatibacter actinomycetemcomitans, Prevotella intermedia, and Fusobacterium nucleatum. Further, 36 computerized-tomography based finite element (FE) models were accomplished, simulating each patient under three loading conditions.
The evaluated clinical parameters were equal for EH and MT implants. Mean IT-FBIC was significantly different between the tested connections (1.17 ± 0.44 mm for EH, and 0.17 ± 0.54 mm for MT, considering all evaluated time periods). No significant microbiological differences could be observed between tested connections. FE analysis showed a significantly higher peak of equivalent (EQV) strain (p = 0.005) for EH (mean 3,438.65 µε) compared to MT (mean 840.98 µε) connection.
Radiographic periimplant bone loss depends on the implant connection type. MT connections showed less periimplant bone loss, compared to EH connections.
评估与采用外六角（EH）和莫氏锥度（MT）连接的种植体周围骨重塑相关的临床、影像学、微生物学和生物力学参数。
12例全口无牙患者在下颌孔间区域植入4颗定制种植体。其中两颗种植体具有相同的宏观设计，但修复连接方式不同。所有患者均接受即刻种植支持式义齿。在随访12个月时评估临床参数（种植体周围探诊深度（PPD）、改良牙龈指数（mGI）和黏膜厚度（MTh））。在随访1、3、6和12个月时获取的标准化数字化根尖周X线片上评估种植体顶部与首次骨与种植体接触点（IT-FBIC）之间的距离。在种植体加载后1、3和6个月收集龈下微生物样本，用于定量检测福赛坦纳菌、牙龈卟啉单胞菌、伴放线聚集杆菌、中间普氏菌和具核梭杆菌。此外，完成了36个基于计算机断层扫描的有限元（FE）模型，模拟每位患者在三种加载条件下的情况。
EH和MT种植体的评估临床参数相等。在测试的连接方式之间，平均IT-FBIC存在显著差异（考虑所有评估时间段，EH为1.17±0.44 mm，MT为0.17±0.54 mm）。在测试的连接方式之间未观察到显著的微生物学差异。有限元分析显示，与MT连接（平均840.98 με）相比，EH连接（平均3438.65 με）的等效应力（EQV）峰值显著更高（p = 0.005）。
种植体周围影像学骨丢失取决于种植体连接类型。与EH连接相比，MT连接的种植体周围骨丢失更少。
