Postdoctoral Researcher, Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas (UFPel), Rio Grande do Sul, Brazil.
PhD student, Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas (UFPel), Rio Grande do Sul, Brazil.
J Prosthet Dent. 2022 Oct;128(4):648-655. doi: 10.1016/j.prosdent.2020.12.029. Epub 2021 Mar 19.
Alveolar ridge regularization involves the smoothing and minimal reduction of rough alveolar bone ridge to achieve adequate bone thickness around the implant. The effect of this procedure on peri-implant health is unclear.
The purpose of this clinical study was to evaluate whether bone regularization affects the clinical and biological parameters of peri-implant health when narrow diameter implants are placed as mandibular implant overdenture retainers during initial healing and after occlusal loading.
The need for mandibular ridge regularization in the anterior mandibular region was analyzed before the placement of 2 implants (2.9×10 mm, Facility; Neodent) in 21 participants provided with mandibular overdentures. Primary stability was measured by the insertion torque and implant stability quotient (ISQ). Clinical and biological evaluations measuring the plaque index, presence of calculus, probing depth, bleeding on probing index, gingival index, secondary stability (ISQ), and interleukine-1β (IL-1β) and tumor necrosis factor-α (TNF-α) concentrations in peri-implant crevicular fluid were measured during osseointegration on days 7, 15, 30, 60, and 90 and after loading on day 180 after implant placement. Multilevel mixed-effects linear regression analysis and the Kaplan-Meier test were used to analyze the data (α=.05).
The ISQ values showed significant differences on days 7 (P<.001) and 15 (P=.002) with higher values and on day 180 (P=.008) with a lower value compared with the baseline value in the ridge regularization group. Additionally, a significant decrease in probing depth was observed on days 60 (P=.008) and 180 (P=.027) compared with that on day 15 after implant placement. In the nonridge regularization group, significant decreases in probing depth were observed on days 30 and 180. Moreover, TNF-α levels in this group were significantly lower on days 30 (P=.001), 60, 90, and 180 (P<.001) when compared with the value on day 7 (P<.001). The ridge regularization group presented with significant differences in TNF-α and IL-1β levels on days 60 (P=.004) and 30 (P=.007), respectively, when compared with the values on day 7. The ISQ and probing depth in the ridge regularization group were associated with changes in TNF-α and IL-1β levels; furthermore, bone type, duration of edentulism, and mandibular bone atrophy were correlated with the clinical outcomes and TNF-α release. The implant survival rate was 67% in the nonridge regularization group and 100% in the ridge regularization group.
Mandibular ridge regularization appeared to be beneficial for peri-implant healing during the early stages and after 3 months of occlusal loading in patients with an atrophic ridge, prolonged time since edentulism, and poor bone quality.
牙槽嵴整复术涉及对粗糙的牙槽嵴进行平滑和最小程度的减少，以达到种植体周围足够的骨厚度。该手术对种植体周围健康的影响尚不清楚。
本临床研究的目的是评估在初始愈合和咬合负荷后，当将窄直径种植体作为下颌种植覆盖义齿的保留体放置时，骨整复术是否会影响种植体周围健康的临床和生物学参数。
在 21 名下颌覆盖义齿患者中，分析了在前下颌区域放置 2 个种植体（2.9×10mm，Facility；Neodent）之前下颌骨前嵴整复术的必要性。通过插入扭矩和种植体稳定性指数（ISQ）测量初级稳定性。在第 7、15、30、60 和 90 天的骨整合期间和植入物放置后第 180 天的负荷后，测量菌斑指数、牙石存在、探诊深度、探诊出血指数、牙龈指数、二次稳定性（ISQ）以及种植体周围龈沟液中的白细胞介素-1β（IL-1β）和肿瘤坏死因子-α（TNF-α）浓度。采用多级混合效应线性回归分析和 Kaplan-Meier 检验进行数据分析（α=.05）。
ISQ 值在第 7 天（P<.001）和第 15 天（P=.002）时具有显著差异，且值较高，而在第 180 天（P=.008）时与基线值相比具有较低值。此外，与植入物放置后第 15 天相比，第 60 天（P=.008）和第 180 天（P=.027）时探诊深度明显减小。在非整复术组中，第 30 天和第 180 天的探诊深度也明显减少。此外，该组第 30 天（P=.001）、第 60、90 和 180 天（P<.001）时 TNF-α 水平显著低于第 7 天（P<.001）。整复术组第 60 天（P=.004）和第 30 天（P=.007）时 TNF-α 和 IL-1β 水平有显著差异。此外，骨类型、无牙时间和下颌骨萎缩与临床结果和 TNF-α 释放有关。非整复术组的种植体存活率为 67%，整复术组为 100%。
对于牙槽嵴萎缩、无牙时间长、骨质量差的患者，在种植体早期愈合和 3 个月的咬合负荷后，下颌骨嵴整复术似乎有利于种植体周围愈合。
