Bambini Fabrizio, Orilisi Giulia, Quaranta Alessandro, Memè Lucia
Department of Clinical Sciences and Stomatology, Polytechnic University of Marche, Via Tronto 10, 60126 Ancona, Italy.
School of Dentistry and Oral Health, Griffith University, Brisbane, QLD 4101, Australia.
Materials (Basel). 2021 Jan 14;14(2):387. doi: 10.3390/ma14020387.
One of the current major challenges in implant therapy is to minimize marginal bone loss around implants, since it can trigger bacterial colonization of the implant's neck, leading to its failure. The present study aimed (1) to scientifically validate a new mathematical rule based on soft tissues thickness, for choosing the correct implant position with respect to the bone level, in order to provide a better tissue adaptation to the abutment/implant surface to avoid bacterial invasion, and (2) to apply this mathematical rule to the Biological Oriented Immediate Loading (B.O.I.L.) surgical protocol, avoiding peri-implant bone resorption. N. 127 implants were inserted following B.O.I.L. protocol: implants were placed according to the mathematical rule Y = X - 3, which correlates the position of the implant from the bone crest level (Y) with the thickness of the soft tissues (X). All the implants were inserted in fresh extraction sockets, and immediately loaded with temporary abutments and prostheses. Bone levels were evaluated through radiographic examination just after surgical procedure (T0), and after 10 days (10D), 6 months (6M), 1 year (1Y), and 5 years (5Y). After 5 years, the implant survival rate was 100%, with a medium marginal bone loss around implants of 0.0704 mm (SD = 0.169 mm). One-way ANOVA, followed by Tukey's multiple comparison test was performed for statistical evaluations ( < 0.05). This protocol provided a safe and successful procedure, with a good soft tissue seal against bacterial challenge. The application of the mathematical rule allows the implant placement in a correct vertical position from the bone crest, avoiding bone resorption and bacterial infiltrations. Moreover, the use of Multi Unit Abutment (MUA) determined a stable biological seal, favouring the implant healing and preserving the adhesion of hemidesmosomes to the titanium of MUA.
种植治疗当前的主要挑战之一是尽量减少种植体周围的边缘骨丢失，因为这会引发种植体颈部的细菌定植，导致种植失败。本研究旨在：（1）科学验证一种基于软组织厚度的新数学规则，以便在骨水平方面选择正确的种植体位置，从而使组织更好地适应基台/种植体表面，避免细菌入侵；（2）将此数学规则应用于生物导向即刻负重（B.O.I.L.）手术方案，避免种植体周围骨吸收。按照B.O.I.L.方案植入了127颗种植体：种植体根据数学规则Y = X - 3放置，该规则将种植体距牙槽嵴顶水平的位置（Y）与软组织厚度（X）相关联。所有种植体均植入新鲜拔牙窝，并立即用临时基台和假体进行负重。在手术后即刻（T0）、10天（10D）、6个月（6M）、1年（1Y）和5年（5Y）通过影像学检查评估骨水平。5年后，种植体存活率为100%，种植体周围平均边缘骨丢失为0.0704 mm（标准差 = 0.169 mm）。采用单因素方差分析，随后进行Tukey多重比较检验进行统计学评估（P < 0.05）。该方案提供了一种安全且成功的手术方法，具有良好的软组织封闭以抵御细菌挑战。数学规则的应用允许将种植体从牙槽嵴顶放置在正确的垂直位置，避免骨吸收和细菌浸润。此外，使用多单位基台（MUA）确定了稳定的生物封闭，有利于种植体愈合并保持半桥粒与MUA钛的粘附。
