Private Practice, Rome, Italy.
ARDEC Academy, Ariminum Odontologica, Rimini, Italy.
Clin Oral Implants Res. 2017 Oct;28(10):1195-1203. doi: 10.1111/clr.12940. Epub 2016 Aug 8.
To evaluate the 10-year post-loading radiological and esthetic outcomes of implants inserted in post-extraction sites and restored with or without platform-switching protocol.
Twenty-two patients were scheduled for maxillary post-extractive implant, using a 13 mm in length and 5.5 mm in diameter implant (Global, Sweden & Martina, Padua, Italy). They randomly received definitive restorations using platform-switching concept (abutment 3.8 mm in diameter: test group) or standard restoration (abutment 5.5 mm in diameter: control group). Outcome measures were survival rates of implants and prostheses, peri-implant marginal bone loss and periodontal indices 10 years after prosthetic loading. Moreover, esthetic parameters including soft tissue buccal peri-implant mucosal levels (REC) and mesial and distal papilla height (PH) were taken at definitive restoration, 2 and 10 years thereafter.
Nineteen implants were analyzed after 10 years of follow-up. No implants nor prostheses failed. The postoperative radiographs demonstrated an overall mean bone loss of 0.18 ± 0.14 mm in the test group and of 0.80 ± 0.40 mm in the control group (P = 0.00108). Test group showed 0.23 ± 0.51 mm of REC gain and PH was of 0.21 ± 0.33 mm on average. On the other side, the control group presented a REC = -0.59 ± 0.80 mm with PH = -1.12 ± 0.55 mm, demonstrating a slight continuous soft tissue shrinkage during the entire follow-up. The mean values were statistically significant different between test and control group for both REC gain (P = 0.01174) and PH (P = 0.0009).
With the limitations of this study, immediate single implant restorations rehabilitated with platform-switching protocol may provide peri-implant alveolar bone-level stability and avoid continuous soft tissue shrinkage after 10 years of prosthetic loading compared to a platform-matching restoration. Further studies involving larger sample sizes are required to confirm these preliminary results.
评估种植体在拔牙窝中植入并采用或不采用平台转换方案修复后 10 年的加载后放射学和美学效果。
22 名患者计划在上颌进行拔牙后种植，使用长度为 13mm、直径为 5.5mm 的种植体（Global，瑞典和 Martina，帕多瓦，意大利）。他们随机接受了采用平台转换概念（直径 3.8mm 的基台：实验组）或标准修复（直径 5.5mm 的基台：对照组）的最终修复。在修复后 10 年，评估了种植体和修复体的存活率、种植体周围边缘骨丧失和牙周指数。此外，在最终修复时、修复后 2 年和 10 年，还测量了包括颊侧软组织种植体黏膜水平（REC）和近远中侧乳头高度（PH）在内的美学参数。
在 10 年的随访后，19 个种植体被分析。没有种植体或修复体失败。术后 X 光片显示，实验组的总体平均骨损失为 0.18±0.14mm，对照组为 0.80±0.40mm（P=0.00108）。实验组 REC 增加了 0.23±0.51mm，PH 平均为 0.21±0.33mm。另一方面，对照组 REC=-0.59±0.80mm，PH=-1.12±0.55mm，在整个随访过程中显示出轻微的软组织持续收缩。实验组 REC 增加（P=0.01174）和 PH（P=0.0009）的平均值与对照组相比有统计学显著差异。
受本研究的限制，与采用平台匹配修复相比，采用平台转换方案即刻单牙种植体修复可在 10 年修复后提供种植体周围牙槽骨水平的稳定性，并避免软组织的持续收缩。需要进一步开展涉及更大样本量的研究来证实这些初步结果。
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