Clinic for Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland.
Statistical Services, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
Clin Oral Implants Res. 2018 Oct;29(10):996-1006. doi: 10.1111/clr.13366. Epub 2018 Sep 20.
To assess the early histological, microbiological, radiological, and clinical response to cemented and screw-retained all-ceramic single-tooth implant-supported reconstructions.
Patients with single-tooth implants were randomly allocated to receive a cemented lithium disilicate crown on a customized zirconia abutment (CEM) or a screw-retained crown with a directly veneered zirconia abutment (SCREW). At the screening visit, at crown insertion and at the 6-month follow-up, clinical parameters were measured at the implant and the contralateral tooth. Marginal bone levels, technical parameters, and esthetic outcomes were measured at the implants. At the 6-month follow-up, a microbiological test was performed and a soft tissue biopsy was harvested at the implants for histological analysis. Inflammatory cells and fibroblasts/-cytes were analyzed at the level of the sulcular epithelium, junctional epithelium, and connective tissue. The histological parameters were analyzed by means of a linear mixed model.
Thirty-three patients completed the study, and implant and crown survival rates were 100% at 6 months. Histologically, the number of inflammatory cells tended to be higher in group CEM (p > 0.05). Moreover, significantly less inflammatory cells and fibroblasts/-cytes were found in the sulcular epithelium compared to the junctional epithelium and supracrestal connective tissue (p < 0.001). Four patients were tested positive for periodontal marker pathogens at the 6-month follow-up, and three of them belonged to group CEM. From crown insertion to the 6-month follow-up, median marginal bone levels changed only minimally and measured 0.31 and 0.32 mm in group CEM and 0.47 and 0.36 mm in group SCREW, respectively. Clinical and esthetic parameters remained stable over time and were comparable between natural teeth and implants as well as between the groups.
Cemented reconstructions were associated with more inflammatory cells, and more patients were diagnosed with periodonto-pathogens. Both types of reconstructions resulted in similar radiological (marginal bone levels) and clinical outcomes (bleeding on probing and probing depth).
评估全瓷单牙种植体支持修复体的早期组织学、微生物学、影像学和临床反应。
将接受单牙种植体的患者随机分配至接受定制氧化锆基台的黏结硅酸锂全瓷冠（CEM）或直接上釉氧化锆基台的螺钉固位冠（SCREW）组。在筛选访视、牙冠戴入时和 6 个月随访时，测量种植体和对侧牙的临床参数。测量种植体的边缘骨水平、技术参数和美学效果。在 6 个月随访时，进行微生物学检测，并在种植体处采集软组织活检进行组织学分析。分析沟上皮、结合上皮和结缔组织内的炎症细胞和纤维母细胞/纤维细胞。采用线性混合模型分析组织学参数。
33 例患者完成了研究，种植体和牙冠的 6 个月生存率均为 100%。组织学上，CEM 组的炎症细胞数量较高（p＞0.05）。此外，与结合上皮和骨上结缔组织相比，沟上皮内的炎症细胞和纤维母细胞/纤维细胞明显较少（p＜0.001）。4 例患者在 6 个月随访时检测到牙周病标志物病原体阳性，其中 3 例属于 CEM 组。从牙冠戴入到 6 个月随访，CEM 组和 SCREW 组的边缘骨水平分别仅轻微变化，分别为 0.31 和 0.32mm，0.47 和 0.36mm。临床和美学参数随时间保持稳定，且在天然牙和种植体之间以及两组之间具有可比性。
黏结修复体与更多的炎症细胞相关，更多的患者被诊断为牙周病病原体阳性。两种类型的修复体均导致相似的影像学（边缘骨水平）和临床结果（探诊出血和探诊深度）。
