Crespi Roberto, Capparé Paolo, Crespi Giovanni, Gastaldi Giorgio, Romanos Georgios E, Gherlone Enrico
Int J Periodontics Restorative Dent. 2019 March/April;39(2):227–232. doi: 10.11607/prd.3292. Epub 2018 Jun 12.
The aim of the present study was to consider the long-term midfacial mucosal outcome around final prosthetic restorations on dental implants placed and loaded immediately after tooth extractions. A total of 42 patients requiring tooth extractions were recruited, and 142 teeth were extracted. Based on the amount of keratinized mucosa (KM), implants were categorized into group A (KM ≥ 2 mm; n = 61) or group B (KM < 2 mm; n = 62). In both groups, all patients received temporary prosthetic restorations immediately after the surgical procedure. Baseline levels were measured at placement of the final prosthetic restoration and patients were followed for 8 years. After the 8-year follow-up, a survival rate of 98.37% was reported. Two implants were lost due to peri-implantitis after 6 and 7 years of function, respectively. Peri-implantitis occurred at 9 implants (3 from group A and 6 from group B) in 8 patients (7.32%). At the 8-year follow-up for group A, an increase in midfacial tissue level of 0.14 ± 0.13 mm (screwed restorations) and 0.16 ± 0.09 mm (cemented restorations) was measured. For group B, a decrease in midfacial tissue level of 0.15 ± 0.09 mm (screwed restorations) and 0.17 ± 0.12 mm (cemented restorations) was reported. Statistically significant differences between groups were measured at 2, 5, and 8 years of follow-up (P < .01). The results demonstrated that the presence of KM is significantly associated with less mucosal inflammation and less gingival recession, regardless of the type of prosthetic restoration (screwed vs cemented).
本研究的目的是探讨拔牙后即刻植入并加载的牙种植体最终修复体周围长期的面中部黏膜转归情况。共招募了42例需要拔牙的患者,拔除了142颗牙齿。根据角化黏膜(KM)的量,种植体被分为A组(KM≥2mm;n = 61)或B组(KM < 2mm;n = 62)。两组患者在手术操作后均立即接受临时修复体。在最终修复体植入时测量基线水平,并对患者进行8年随访。8年随访后,报告的生存率为98.37%。分别在功能6年和7年后,有2颗种植体因种植体周围炎而丢失。8例患者(7.32%)的9颗种植体发生了种植体周围炎(A组3颗,B组6颗)。在A组8年随访时,面中部组织水平增加了0.14±0.13mm(螺丝固位修复体)和0.16±0.09mm(粘结固位修复体)。对于B组,报告面中部组织水平下降了0.15±0.09mm(螺丝固位修复体)和0.17±0.12mm(粘结固位修复体)。在随访2年、5年和8年时,两组间存在统计学显著差异(P < 0.)。结果表明,无论修复体类型(螺丝固位与粘结固位)如何,KM的存在与较少的黏膜炎症和较少的牙龈退缩显著相关。