Hamudi Nasreen, Barnea Eitan, Weinberg Evgeny, Laviv Amir, Mijiritsky Eitan, Matalon Shlomo, Chaushu Liat, Kolerman Roni
Private Practice, Calanswa 40640, Israel.
Private Practice, Tel Aviv 6416304, Israel.
J Clin Med. 2021 Dec 24;11(1):74. doi: 10.3390/jcm11010074.
Repeated abutment disconnection/reconnection may compromise the mucosal barrier and result in crestal bone level changes. The clinical significance of this phenomenon is not yet clear, as most studies on this topic are short-term. Therefore, the aim of the present study was to evaluate the influence of abutment disconnections and reconnections on peri-implant marginal bone loss over a medium-term follow-up period.
Twenty-one patients (6 men and 15 women) with a mean age 66.23 ± 9.35 year at the time of implant placement were included. All patients who received two adjacent nonsubmerged implants were randomly assigned into one of the two groups: definitive multiunit abutments (DEFs) connected to the implant that were not removed (test group) or healing abutments (HEAs) placed at surgery, which were disconnected and reconnected 3-5 times during the prosthetic phase (control group). Peri-implant marginal bone levels (MBL) were measured through periapical X-rays images acquired immediately after the surgery (baseline), at 4-7 months immediately after prosthetic delivery, and at 1-year and 3-year follow-up visits.
No implant was lost or presented bone loss of more than 1.9 mm during the 3-year follow-up; thus, the survival and success rate was 100%. Peri-implant mucositis was noticed in 38.1% DEFs and 41.9% of HEAs at the 3-year follow-up assessment. At the end of 3 years, the MBL was -0.35 ± 0.69 mm for participants in the DEFs group and -0.57 ± 0.80 mm for the HEAs group, with significant statistical difference between groups.
Immediate connection of the multiunit abutments reduced bone loss in comparison with 3-5 disconnections noted in the healing abutments 3 years after prosthetic delivery. However, the difference between the groups was minimal; thus, the clinical relevance of those results is doubtful.
反复的基台断开/重新连接可能会损害黏膜屏障并导致牙槽嵴骨水平改变。由于关于该主题的大多数研究都是短期的，这一现象的临床意义尚不清楚。因此，本研究的目的是在中期随访期内评估基台断开和重新连接对种植体周围边缘骨丢失的影响。
纳入21例患者（6例男性和15例女性），种植体植入时平均年龄为66.23±9.35岁。所有接受两个相邻非潜入式种植体的患者被随机分为两组之一：连接到种植体的最终多单位基台（DEFs）未被移除（试验组），或在手术时放置愈合基台（HEAs），在修复阶段断开并重新连接3 - 5次（对照组）。通过术后立即（基线）、修复体交付后4 - 7个月、1年和3年随访时采集的根尖X线图像测量种植体周围边缘骨水平（MBL）。
在3年随访期间，没有种植体丢失或出现超过1.9 mm的骨丢失；因此，生存率和成功率为100%。在3年随访评估中，38.1%的DEFs和41.9%的HEAs出现种植体周围黏膜炎。3年后，DEFs组参与者的MBL为 - 0.35±0.69 mm，HEAs组为 - 0.57±0.80 mm两组之间存在显著统计学差异。
与修复体交付3年后愈合基台出现的3 - 5次断开相比，多单位基台的立即连接减少了骨丢失。然而，两组之间的差异很小；因此，这些结果的临床相关性值得怀疑。
