Department of Oral Rehabilitation, Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand.
Department of Oral Sciences, Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand.
Clin Implant Dent Relat Res. 2019 Apr;21(2):344-351. doi: 10.1111/cid.12733. Epub 2019 Feb 14.
Single implant crowns have become the preferred rehabilitation treatment option for replacing a missing tooth.
This study evaluates 5-year clinical success of using tilted implants placed immediately after extraction followed by rehabilitation with all-ceramic crowns.
Twenty-seven participants requiring 28 single implant crowns in the aesthetic zone of maxilla were recruited to participate in a single-arm clinical trial. All participants were rehabilitated according to immediate implant placement using CP grade 4 titanium implants with roughened surfaces and a 12°-angled platform. Provisional implant crowns were connected within 4 hours of implant placement and loaded according to progressive loading protocol. At 8 weeks (baseline), definitive screw-retained crowns fabricated using densely sintered zirconia abutments with the veneering porcelain were delivered. Participants were followed up to 5 years and 16 participants with 17 single implant crowns attended Year 5 recall. Data collection included changes in marginal bone levels (MBLs), mid-buccal mucosal levels (MBMLs), implant stability quotient (ISQ) values, and any prosthodontic maintenance issues.
The mean changes in MBLs at each recall was bone fill of 0.5 ± 1.18 mm (surgery-baseline), increase of 0.1 ± 0.57 mm (baseline-Year 1), and marginal bone loss of 0.1 ± 0.25 mm (Years 1-5). A minimal change occurred with the MBMLs during the observation period. The mean ISQ value at each time point increased from 65.1 (implant placement), to 67.4 (baseline) and 69.9 (Years 1 and 5). Prosthodontic maintenance issues occurred only during the first year which included fracture of veneering ceramic and zirconia abutment as well as aesthetic concerns.
Within the limitations of this study, the data collected would suggest that replacing a single missing tooth using titanium oral implants with 12° platform tilt and zirconia abutments can be a successful rehabilitation option in the esthetically demanding zone of anterior maxilla.
单颗种植体牙冠已成为修复缺失牙的首选治疗方案。
本研究评估了即刻植入倾斜种植体并用全瓷冠修复后 5 年的临床成功率。
招募了 27 名需要在上颌美学区植入 28 颗单颗种植体牙冠的患者参与单臂临床试验。所有患者均根据即刻种植体植入原则，使用 CP 四级钛种植体和粗糙表面、12°平台进行治疗。种植体植入后 4 小时内连接临时牙冠，并按照逐步加载方案加载。8 周（基线）时，使用密烧结氧化锆基台和饰面瓷制作最终螺钉固位牙冠。患者随访 5 年，16 名患者（17 颗单颗种植体牙冠）参加了第 5 年的随访。数据收集包括边缘骨吸收（MBL）、颊侧黏膜水平（MBML）、种植体稳定性指数（ISQ）值的变化以及任何修复体维护问题。
每次随访的 MBL 平均变化为：种植体植入时骨增量 0.5±1.18mm（手术-基线），基线至第 1 年增加 0.1±0.57mm，第 1 年至第 5 年边缘骨吸收 0.1±0.25mm。MBML 在观察期间基本无变化。各时间点的平均 ISQ 值从 65.1（种植体植入）增加到 67.4（基线）和 69.9（第 1 年和第 5 年）。修复体维护问题仅在第一年发生，包括饰面陶瓷和氧化锆基台的破裂以及美学问题。
在本研究的限制范围内，收集的数据表明，在前上颌美学区使用具有 12°平台倾斜和氧化锆基台的钛种植体替代单个缺失牙是一种成功的修复选择。
