Doctor Private Practice, Rome, Italy.
Department of Surgical Sciences (DISC), Division of Prosthodontics, University of Genoa, Genoa, Italy.
Clin Implant Dent Relat Res. 2018 Dec;20(6):976-982. doi: 10.1111/cid.12683. Epub 2018 Oct 11.
Soft tissue stability is crucial to obtain and maintain optimal esthetic results.
This study aimed to investigate, over 5 years, the soft tissue response using a conical abutment together with the "one-abutment one-time" (OA-OT) protocol in the restoration of implants inserted in the anterior esthetic area.
From January 2011 to January 2012, all consecutive patients requiring an implant n the maxillary area between canines were enrolled. After submerged healing and osseointegration, a definitive abutment with a provisional crown was inserted. After 1 month, the definitive crown was delivered (Tdef). Analog impressions were taken before tooth extraction (T0), at implant insertion Timpl, and Tdef, and at 12 months (T1) and 60 months (T5). Casts were scanned and superimposed using a dedicated software. Differences in vertical height of soft tissue margins between the digitized model casts were calculated and paired sample t test was conducted to compare results. To detect the potential role of biotype, groups (thick vs. thin) were compared by analysis of variance with general linear model.
Twenty-five patients were enrolled. Three patients dropped out. At the 60-month, 22 patients (12 men and 10 women with mean age of 68.3 ± 11 years) concluded the study follow-up. Horizontal changes demonstrated gain of 1.06 mm at Timpl, 0.94 mm at Tdef, 0.92 mm at T1 and 0.97 mm at T5 compared to T0. Vertical changes demonstrated gain of 0.84 mm at Timpl, 0.11 mm at Tdef, 0.29 mm at T1 and 0.59 mm at T5 compared to T0. The analysis of variance showed a significant better performance of thick biotype in soft tissue horizontal width (P = .022). No statistical differences were noticed for vertical width (P = .111).
The use of a conical abutment together with the OA-OT approach allowed longitudinal stable soft tissue dimensions.
软组织稳定性对于获得和维持最佳美观效果至关重要。
本研究旨在探讨使用锥形基台并采用“一次一基台”(OA-OT)方案在前牙美学区植入种植体后,5 年内软组织的反应。
2011 年 1 月至 2012 年 1 月,所有连续需要在前牙区植入种植体的患者均被纳入研究。在愈合期和骨整合后,植入临时基台和临时冠。1 个月后,即 Tdef 时,植入最终基台和最终冠。在拔牙前(T0)、种植体植入时(Timpl)、Tdef 时、12 个月(T1)和 60 个月(T5)时,分别进行模拟印模和数字化模型。使用专用软件对模型进行扫描和叠加。计算软组织边缘垂直高度的差异,并通过配对样本 t 检验比较结果。为了检测生物型的潜在作用,通过一般线性模型的方差分析比较了厚型和薄型两组。
共纳入 25 名患者,其中 3 名患者脱落。60 个月时,22 名患者(12 名男性,10 名女性,平均年龄 68.3±11 岁)完成了研究随访。水平方向上,Timpl 时增加了 1.06mm,Tdef 时增加了 0.94mm,T1 时增加了 0.92mm,T5 时增加了 0.97mm,与 T0 相比均有显著差异。垂直方向上,Timpl 时增加了 0.84mm,Tdef 时增加了 0.11mm,T1 时增加了 0.29mm,T5 时增加了 0.59mm,与 T0 相比均有显著差异。方差分析显示,厚型生物型在软组织水平宽度方面表现更好(P=0.022)。但在垂直宽度方面无统计学差异(P=0.111)。
使用锥形基台并采用“一次一基台”方案可实现软组织长期稳定的尺寸。