Graduate Periodontics, Department of Oral Health and Rehabilitation, School of Dentistry, University of Louisville, Louisville, Kentucky, USA.
Division of Periodontics, Department of Dentistry, Tri-Service General Hospital, Taipei, Taiwan.
J Periodontol. 2020 Dec;91(12):1609-1620. doi: 10.1002/JPER.20-0030. Epub 2020 Jul 5.
Implants with platform-switching (PS) design have been demonstrated to reduce marginal bone loss. However, the influence on peri-implant soft tissue healing is unclear. This study was designed to investigate its effect on peri-implant soft tissue healing after implant uncovery.
Non-smokers needing two implants in different quadrants were recruited in this study. For each individual, one PS and one platform-matching (PM) implants were placed using two-stage protocol. Following 2 to 8 months of healing, all implants were uncovered and connected to the corresponding healing abutments. Clinical measurements and peri-implant crevicular fluid (PICF) were taken at 1-, 2-, 4-, and 6-week after 2nd stage surgery. The cytokine concentrations in PICF were analyzed. Peri-implant mucosa (1 × 2 × 2 mm) was harvested around the healing abutment for the analysis of gene expression at uncovery and 6-week post-uncovery.
Eighteen participants (nine males; 51.7 ± 14.9 years) were recruited. Compared to PM, PS showed significantly lower probing depth (PD) at 1- and 2-week as well as modified sulcus bleeding index (mSBI) at 1-, 4-, and 6-week (P < 0.05). Over time, a decrease in osteoprotegerin and interleukin-1β concentrations in PICF along with an increase in receptor activator of unclear factor kappa-B ligand, periostin, and peroxidasin gene expressions in peri-implant mucosa were noted within both groups (P < 0.05) without significant intergroup differences.
Within the limits, implants with PS design rendered significant benefits over PM design in PD and mSBI reduction during a 6-week healing. However, molecular changes within PICF and peri-implant mucosa as a response to PM and PS appear negligible.
具有平台转换(PS)设计的种植体已被证明可减少边缘骨丧失。然而,其对种植体周围软组织愈合的影响尚不清楚。本研究旨在探讨其对种植体二期手术后软组织愈合的影响。
本研究纳入需要在不同象限植入两颗种植体的非吸烟患者。对于每位患者,采用两期手术植入一颗 PS 种植体和一颗平台匹配(PM)种植体。二期愈合 2 至 8 个月后,所有种植体均暴露并与相应的愈合基台连接。二期手术后第 1、2、4 和 6 周,测量临床指标和种植体周围龈沟液(PICF),并分析 PICF 中的细胞因子浓度。在暴露和暴露后 6 周时,围绕愈合基台采集种植体周围黏膜(1×2×2mm),分析基因表达情况。
共纳入 18 名患者(9 名男性,平均年龄 51.7±14.9 岁)。与 PM 相比,PS 在二期手术后第 1 天和第 2 天的探诊深度(PD)和第 1、4 和 6 天的改良龈沟出血指数(mSBI)明显较低(P<0.05)。随着时间的推移,两组患者的 PICF 中骨保护素和白细胞介素-1β浓度逐渐降低,而种植体周围黏膜中核因子κ B 受体激活剂配体、骨桥蛋白和过氧化物酶的基因表达逐渐增加(P<0.05),但两组之间无明显差异。
在本研究的限制范围内,PS 设计的种植体在二期手术后 6 周的愈合期间在 PD 和 mSBI 降低方面优于 PM 设计的种植体。然而,PM 和 PS 对 PICF 和种植体周围黏膜的分子变化影响很小。