即刻负重或延期修复即刻植入物的面部黏膜水平：一项中期研究。
Facial mucosal level of single immediately placed implants with either immediate provisionalization or delayed restoration: An intermediate-term study.
机构信息
Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI.
Department of Biomedical Engineering, College of Engineering, Ann Arbor, MI.
出版信息
J Periodontol. 2021 Sep;92(9):1213-1221. doi: 10.1002/JPER.20-0746. Epub 2021 Jan 20.
BACKGROUND
Immediately placed single implants with either immediate provisionalization (test) or delayed restoration (control) were followed for up to 1 year in our previous randomized clinical trial. Peri-implant tissues continue to remodel after implants are in function. Therefore, the primary aim of this study was to evaluate the facial mucosal level changes in the intermediate term between the two groups and to study potential factors influencing the mucosal level change.
METHODS
Patients who had already completed the previous clinical trial by receiving a single immediately placed implant were re-invited to this study. The facial mucosal level as well as the other peri-implant hard and soft tissue dimensions and conditions were measured clinically, radiographically and with ultrasound. These data were compared between the test and control implants. The mucosal level change as the function of the final crown contour, measured as the abutment-crown angle (ACA), was estimated with a linear regression model.
RESULTS
Twenty-eight patients (n of test/control = 16/12) with a mean 30-month follow-up were recruited. The mean mucosal level change was -0.38 mm (control) and 0.06 mm (test), without statistical difference between the two groups. The other clinical, radiographic, and ultrasound parameters were not statistically different. ACA was statistically significant associated with the recession (P = 0.02). The estimate effect was 0.25 mm per 10° increase (adjusted R = 0.18; 95% CI, 0.02 to 0.49 mm). After adjusting for vertical implant position, implant abutment angle and the group, the effect became borderline significant (P = 0.09).
CONCLUSIONS
Peri-implant tissues, including the mucosal level change of immediately placed implants with either immediate provisionalization or delayed restoration remained stable and did not differ between the groups in the intermediate term. The final crown angle, influenced by implant position and abutment angle, might be associated with mucosal margin level change.
背景
在我们之前的随机临床试验中，对即刻植入并即刻临时修复（试验组）或延期修复（对照组）的单颗种植体进行了长达 1 年的随访。种植体在行使功能后，其周围的组织仍会持续改建。因此，本研究的主要目的是评估两组间中期种植体唇侧黏膜的变化，并研究可能影响黏膜水平变化的潜在因素。
方法
邀请已完成之前临床试验（植入单颗即刻种植体并接受即刻临时修复或延期修复）的患者参加本研究。临床、影像学和超声检查测量唇侧黏膜水平以及种植体周围软硬组织的其他维度和状况。比较两组间的测量值。采用线性回归模型，根据最终修复体冠边缘轮廓（测量为基台-冠角，ACA）评估黏膜水平的变化。
结果
共招募了 28 名患者（试验组/对照组 n = 16/12），平均随访 30 个月。对照组和试验组的黏膜水平平均变化分别为-0.38mm 和 0.06mm，两组间无统计学差异。其他临床、影像学和超声参数也无统计学差异。ACA 与退缩有统计学显著相关性（P = 0.02）。估计效应为每增加 10°，黏膜退缩 0.25mm（调整后的 R = 0.18；95%CI，0.02 至 0.49mm）。调整种植体垂直位置、基台角度和分组后，该相关性具有统计学意义（P = 0.09）。
结论
即刻植入并即刻临时修复或延期修复的种植体周围组织，包括黏膜水平变化，在中期保持稳定，两组间无差异。受种植体位置和基台角度影响的最终修复体冠角度可能与黏膜边缘水平变化相关。
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