Department of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, Rome, Italy.
Clin Implant Dent Relat Res. 2019 Feb;21(1):52-59. doi: 10.1111/cid.12693. Epub 2018 Nov 26.
To clinically, biochemically, and microbiologically evaluate the influence of crown margins position on one-stage laser-microgrooved implants.
Twenty-one-stage titanium implants with a laser-microgrooved collar surface, supporting screwed, single crown restorations, were placed in 20 partially edentulous patients and evaluated. Clinical parameters included modified plaque index, modified gingival index, peri-implant probing pocket depth, bleeding on probing, and distance between implant shoulder and mucosal margin. The parameters were recorded at baseline (crowns delivery) and at every 6-month recall visit, until the end of the 3 years follow-up period. At the same time intervals, radiographic marginal bone levels were assessed at the mesial and distal aspect of the implant sites. For biochemical analysis, the volume of the peri-implant sulcus fluid, and its levels of interleukin-1beta (IL-1β), interleukin-6 (IL-6), and of tumor necrosis factor-α, were utilized to evaluate the peri-implant health conditions at the end of the 3-year follow-up period. At the same time, microbiological analysis, including the concentration of five putative periodontal pathogens (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Treponema denticola, and Tannerella forsythensis), were assessed. The crown margins positions were classified into four groups (A = intracrevicular position >2 mm, B = intracrevicular position ≤2 mm/<1 mm, C = intracrevicular position ≤1 mm/<0 mm, and D = extracrevicular position), and the biochemical, and microbiological parameters were evaluated at 3 years.
No statistical differences of clinical and biochemical parameters were found between the four groups. In group A, compared to groups B, C, and D, a statistically significant higher concentration of putative periodontal pathogens was found.
Results showed that the intracrevicular deeper position of the restoration margin does not influence the clinical and biochemical peri-implant parameters. The deeper position of the crown margin is associated with a greater amount of putative periodontal pathogenic microflora colonization.
临床、生化和微生物学评估冠边缘位置对一期激光微沟槽种植体的影响。
将 21 个具有激光微沟槽颈圈表面的钛种植体，支持螺丝固定，单个冠修复体，植入 20 名部分缺牙患者中，并进行评估。临床参数包括改良菌斑指数、改良龈指数、种植体探查袋深度、探诊出血和种植体肩与黏膜边缘之间的距离。这些参数在基线（牙冠交付）和每 6 个月随访时记录，直到 3 年随访结束。在相同的时间间隔内，评估种植体部位的近中和远中边缘骨水平的放射影像学。同时，利用种植体周围沟液的体积及其白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）和肿瘤坏死因子-α的水平，来评估 3 年随访结束时种植体周围的健康状况。同时，进行微生物学分析，包括 5 种潜在牙周病原体（伴放线放线杆菌、牙龈卟啉单胞菌、中间普氏菌、齿密螺旋体和福赛坦氏密螺旋体）的浓度。将冠边缘位置分为 4 组（A=龈沟内位置>2mm，B=龈沟内位置≤2mm/<1mm，C=龈沟内位置≤1mm/<0mm，D=龈沟外位置），并在 3 年后评估生化和微生物学参数。
在 4 组中，临床和生化参数无统计学差异。在 A 组中，与 B、C 和 D 组相比，发现潜在牙周病原体的浓度显著更高。
结果表明，修复体边缘的龈下更深位置不会影响种植体周围的临床和生化参数。冠边缘更深的位置与更多的潜在牙周病原微生物群定植有关。
