Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio.
Professor, Division of Oral and Maxillofacial Surgery, The Ohio State University College of Dentistry, Columbus, Ohio.
J Prosthet Dent. 2022 Dec;128(6):1265-1274. doi: 10.1016/j.prosdent.2021.03.030. Epub 2021 May 24.
Patients diagnosed with a cleft palate often have a congenitally missing maxillary lateral incisor. The congenital cleft presents the practitioner with challenges including the quantity and quality of bone, a surgically managed cleft correction, and limited clinical space.
The purpose of the present prospective investigation was to report preliminary results at the 1-year follow-up for this planned 5-year investigation of narrow diameter implants used to restore a missing lateral incisor in patients with a cleft palate.
Fourteen study participants with a cleft palate and a missing maxillary lateral incisor were enrolled based on established criteria. Narrow diameter implants (AstraTech OsseoSpeed TX 3.0S and 3.5 mm) were placed by using a 2-stage protocol and restored. All study participants received an Atlantis abutment and a cement-retained crown. Four probing depth measurements and bleeding on probing were measured at baseline and at 1 year. Probing depth measurements were evaluated using a 2-way repeated measures ANOVA with Tukey-Kramer multiple comparisons tests. Radiographic marginal bone loss was measured at 1-year by using a digital subtraction technique and evaluated by using a repeated measures ANOVA. Pretreatment cone beam computed tomography (CBCT) images were used to measure a mean gray level that was proportional to bone mineral density (BMD) in the implant site. One-way mixed ANOVA was used to compare the mean gray level and average implant stability quotient (ISQ) loading. A Pearson correlation was also tested between those parameters (α=.05) for each statistical analysis.
The mean marginal bone loss at 1 year was 0.601 ±0.48 mm. Regarding probing depth measurements, a 2-way repeated measures ANOVA found both the location (P=.012) and time (P=.009) were significant. The Tukey-Kramer multiple comparisons test showed a significant difference between the buccal and distal site (P=.006) from baseline to 1-year follow-up.
Narrow diameter implants are a reliable treatment for replacing a missing lateral incisor in patients with a cleft palate at 1 year, with an implant survival rate of 100% and implant success rate of 94% using the established criteria. A negative association was found between the bone mineral density and the implant stability in the alveolar cleft site of a patient with a cleft palate. The peri-implant soft tissue probe depths exhibited significant change during the first year.
诊断为腭裂的患者通常会先天性缺失上颌侧切牙。先天性裂隙给医生带来了挑战，包括骨量和质量、手术矫正裂隙以及有限的临床空间。
本前瞻性研究的目的是报告使用窄直径种植体修复腭裂患者缺失侧切牙的 5 年计划研究的 1 年随访的初步结果。
根据既定标准，纳入 14 名腭裂伴上颌侧切牙缺失的研究参与者。使用两阶段方案放置窄直径种植体（AstraTech OsseoSpeed TX 3.0S 和 3.5 毫米）并进行修复。所有研究参与者均接受 Atlantis 基台和粘结固位冠。基线和 1 年时测量 4 次探诊深度和探诊出血。使用双向重复测量方差分析和 Tukey-Kramer 多重比较检验评估探诊深度测量值。使用数字减影技术在 1 年时测量放射状边缘骨丢失，并使用重复测量方差分析进行评估。使用治疗前锥形束计算机断层扫描（CBCT）图像测量与种植部位骨矿物质密度（BMD）成正比的平均灰度值。使用单向混合方差分析比较平均灰度值和平均种植体稳定性指数（ISQ）加载值。对于每个统计分析，还进行了 Pearson 相关性检验（α=.05）。
1 年时的平均边缘骨丢失为 0.601 ±0.48 毫米。关于探诊深度测量值，双向重复测量方差分析发现位置（P=.012）和时间（P=.009）均有显著差异。Tukey-Kramer 多重比较检验显示，从基线到 1 年随访，颊侧和远中侧之间存在显著差异（P=.006）。
在 1 年时，使用窄直径种植体治疗腭裂患者缺失侧切牙是一种可靠的方法，种植体存活率为 100%，成功率为 94%，使用既定标准。在腭裂患者牙槽裂部位，发现骨矿物质密度与种植体稳定性呈负相关。植入物周围软组织探针深度在第一年有显著变化。
