Pellicer-Chover Hilario, Peñarrocha-Diago Maria, Aloy-Prosper Amparo, Canullo Luigi, Peñarrocha-Diago Miguel, Peñarrocha-Oltra David
Collaborating Professor of Master in Oral Surgery and Implant Dentistry, Oral Surgery Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain.
Associate Professor of Oral Surgery, Oral Surgery Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain.
J Oral Maxillofac Surg. 2019 Mar;77(3):515-527. doi: 10.1016/j.joms.2018.11.002. Epub 2018 Nov 12.
Preserving peri-implant bone and reducing exposure of the rough implant surface might influence long-term outcomes of implant therapy. The aim of this study was to compare peri-implant clinical and radiologic parameters after crestal and subcrestal dental implant placement at 36 months' follow-up.
We carried out a randomized clinical trial involving partially edentulous patients in need of an implant-supported, partial fixed dental prosthesis or a single crown. Patients were randomized according to the implant insertion depth: implants placed approximately 2 mm below the bone crest (test group) or implants placed at bone crest level (control group). They were evaluated 6, 12, 24, and 36 months after prosthetic loading. Peri-implant marginal bone loss was the primary outcome, and the following secondary outcomes were registered: coronal bone changes, plaque index, probing depth, modified bleeding index, retraction and width of the peri-implant mucosa, and peri-implant health condition. Implant survival and success rates after 36 months' follow-up were calculated.
The study comprised 128 patients (83 men and 45 women; mean age, 54.4 ± 12.2 years) and a total of 265 implants (133 in control group and 132 in test group). No statistically significant differences in the peri-implant clinical parameters were found. After 3 years' follow-up, 53.4% of the crestal implants and 25.8% of the subcrestal implants presented marginal bone loss, with a mean exposed rough surface of -0.2 ± 0.3 mm and -0.09 ± 0.1 mm, respectively (P = .001). The overall success rate was 99.6%.
Crestal and subcrestal implants showed similar clinical outcomes 3 years after prosthetic loading. Significant differences were observed in the radiologic parameters, showing less peri-implant marginal bone loss with subcrestal implants.
保留种植体周围骨组织并减少粗糙种植体表面的暴露可能会影响种植治疗的长期效果。本研究的目的是比较在36个月随访时，牙槽嵴顶和牙槽嵴下种植体植入术后种植体周围的临床和放射学参数。
我们进行了一项随机临床试验，纳入了需要种植体支持的部分固定义齿或单冠修复的部分牙列缺损患者。根据种植体植入深度将患者随机分组：种植体植入牙槽嵴顶下方约2mm处（试验组）或种植体植入牙槽嵴顶水平（对照组）。在修复体加载后6、12、24和36个月对患者进行评估。种植体周围边缘骨吸收是主要观察指标，同时记录以下次要观察指标：冠方骨变化、菌斑指数、探诊深度、改良出血指数、种植体周围黏膜退缩和宽度以及种植体周围健康状况。计算36个月随访后的种植体存留率和成功率。
本研究共纳入128例患者（83例男性和45例女性；平均年龄54.4±12.2岁），共植入265枚种植体（对照组133枚，试验组132枚）。种植体周围临床参数未发现统计学上的显著差异。3年随访后，牙槽嵴顶种植体中有53.4%出现边缘骨吸收，牙槽嵴下种植体中有25.8%出现边缘骨吸收，平均暴露的粗糙表面分别为-0.2±0.3mm和-0.09±0.1mm（P = 0.001）。总体成功率为99.6%。
修复体加载3年后，牙槽嵴顶种植体和牙槽嵴下种植体显示出相似的临床结果。放射学参数存在显著差异，牙槽嵴下种植体的种植体周围边缘骨吸收较少。
