Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Vilnius Research Group, Vilnius, Lithuania.
Clin Implant Dent Relat Res. 2020 Aug;22(4):497-506. doi: 10.1111/cid.12903. Epub 2020 Apr 6.
Aims of the study were: (a) to register crestal bone loss around 1.5 mm subcrestally placed implants and epicrestally placed implants with soft tissue tenting technique, (b) to record bone remodeling in subcrestal group, and (c) to determine the increase of vertical soft tissues after tenting.
Thirty-two patients with vertically thin tissues of 2 mm or less received 40 submerged bone level platform-switched implants, divided into two groups-(a) 1.5 mm subcrestally placed implants and (b) epicrestally placed implants with soft tissue tenting over 2 mm healing abutments. At the second stage surgery, implants received 4 mm healing abutments, soft tissue thickness was measured in epicrestal group, and later implants were restored with zirconia-based screw-retained single restorations. Radiological images were taken at the second stage surgery, restoration delivery and after 2 years of follow-up. Bone loss was calculated as a distance between implant neck and first radiographically visible bone-to-implant contact. Bone remodeling was calculated as a distance between the bone crest and implant neck. Mann-Whitney U test was used for statistical analysis, significance set to 0.05.
After 2 years of follow-up, Group 1 (subcrestal) had 0.18 ± 0.32 mm of bone loss, Group 2 (epicrestal with 2 mm healing abutment) had 0.51 ± 0.4 mm of bone loss, with statistically significant difference (P = .001). Bone remodeling in Group 1 (subcrestal) was 1.17 ± 0.51 mm. Vertical tissue thickness in epicrestal group before the intervention was 1.85 ± 0.26 and 3.65 ± 0.41 mm after the use of 2 mm healing abutment, with a statistical difference (P = .005).
Subcrestal implant placement can significantly reduce crestal bone loss, compared to vertical soft tissue thickening by tenting of epicrestally placed implants, although soft tissue tenting can significantly increase soft tissue thickness.
本研究的目的是：(a) 记录在 1.5mm 种植体骨下放置和使用软组织帐篷技术的种植体骨嵴顶放置的种植体周围的牙槽嵴骨吸收；(b) 记录骨改建在骨下放置组中的情况；(c) 确定帐篷术后垂直软组织的增加量。
32 名垂直骨组织厚度为 2mm 或更薄的患者接受了 40 个植入物，分为两组-(a) 1.5mm 骨下放置种植体；(b) 使用软组织帐篷覆盖 2mm 愈合基台的种植体骨嵴顶放置。在第二期手术中，植入物接受了 4mm 愈合基台，在嵴顶组测量软组织厚度，随后用氧化锆基螺钉固位单修复体进行修复。第二期手术、修复体交付和 2 年随访时拍摄放射图像。骨损失计算为种植体颈部和第一次影像学可见骨-种植体接触之间的距离。骨改建计算为骨嵴和种植体颈部之间的距离。采用曼-惠特尼 U 检验进行统计学分析，显著性水平为 0.05。
随访 2 年后，第 1 组（骨下放置）骨损失为 0.18±0.32mm，第 2 组（嵴顶放置，使用 2mm 愈合基台）骨损失为 0.51±0.4mm，差异有统计学意义（P=0.001）。第 1 组（骨下放置）的骨改建为 1.17±0.51mm。在干预前，嵴顶组的垂直组织厚度为 1.85±0.26mm，使用 2mm 愈合基台后为 3.65±0.41mm，差异有统计学意义（P=0.005）。
与使用软组织帐篷技术的嵴顶放置种植体相比，骨下放置种植体可显著减少牙槽嵴骨吸收，尽管软组织帐篷技术可显著增加软组织厚度。
