Vazouras Konstantinos, Gholami Hadi, Margvelashvili-Malament Mariam, Kim Yong Jeong, Finkelman Matthew, Weber Hans-Peter
Department of Prosthodontics, Tufts School of Dental Medicine, Boston, MA.
Department of Public Health and Community Service, Tufts School of Dental Medicine, Boston, MA.
J Prosthodont. 2022 Oct;31(8):673-680. doi: 10.1111/jopr.13520. Epub 2022 May 16.
To assess the effect of implant abutment material and soft tissue thickness on the peri-implant soft tissue color using spectrophotometry and to evaluate gingival esthetics and patient satisfaction with three different abutments.
Twenty-five patients with a missing maxillary tooth in the esthetic area received an endosseous implant using a two-stage protocol. Gray titanium, pink anodized titanium, and hybrid zirconia custom abutments were fabricated for each participant and inserted for one week with a cross-over design in a randomized manner. Color measurements were made using a spectrophotometer comparing midfacial peri-implant soft tissue and marginal gingiva of the contralateral tooth. CIE Lab color scale was used following the formula: ΔE = [(∆L) + (∆a) + (∆b) ] . PES scores were recorded, and patient satisfaction questionnaires were completed at each abutment change visit and at 1-year follow-up. Statistical analysis was performed using Friedman's test and the Wilcoxon signed-rank test with Bonferroni correction as well as the Mann-Whitney U test (α = 0.05).
Abutment material type significantly affected the ΔΕ values of the peri-implant mucosa when compared to the contralateral teeth. At baseline, the highest ΔΕ means ± standard deviation (SD) values were obtained with gray titanium (11.25 ± 2.98), followed by pink anodized titanium (9.90 ± 2.51), and zirconia abutments (6.46 ± 1.43). Differences were statistically significant irrespective of soft tissue thickness. The highest PES values were obtained with zirconia abutments (10.88 ± 0.88), followed by pink anodized titanium (10.12 ± 1.13) and the lowest with gray titanium (9.68 ± 1.41). PES differences were significant only for the thin soft tissue group. Regarding patient satisfaction, VAS scores for the pink anodized and zirconia hybrid abutment groups were higher than the gray titanium group for each question.
The color difference between soft tissues around teeth and implants was significant in all groups regardless of tissue thickness. The hybrid zirconia abutments resulted in the least color difference, followed by pink anodized and gray titanium. Significantly different PES values were recorded only for the thin tissue group. There was no significant difference in patient satisfaction between zirconia and pink anodized abutments at the 1-year follow up. Pink anodized abutments represent a good esthetic alternative to zirconia hybrid abutments especially in mechanically challenging situations.
采用分光光度法评估种植体基台材料和软组织厚度对种植体周围软组织颜色的影响，并评估三种不同基台的牙龈美学效果和患者满意度。
25例上颌美观区单颗牙缺失患者采用两阶段方案植入骨内种植体。为每位参与者制作灰色钛、粉色阳极氧化钛和混合氧化锆定制基台，并采用交叉设计随机插入一周。使用分光光度计对种植体周围面部中部软组织和对侧牙齿的边缘牙龈进行颜色测量。采用CIE Lab色标，计算公式为：ΔE = [(∆L)² + (∆a)² + (∆b)²]¹/² 。记录PES评分，并在每次更换基台时和1年随访时完成患者满意度问卷。采用Friedman检验、经Bonferroni校正的Wilcoxon符号秩检验以及Mann-Whitney U检验进行统计分析（α = 0.05）。
与对侧牙齿相比，基台材料类型对种植体周围黏膜的ΔΕ值有显著影响。基线时，灰色钛基台获得的ΔΕ均值±标准差（SD）最高（11.25 ± 2.98），其次是粉色阳极氧化钛基台（9.90 ± 2.51），氧化锆基台最低（6.46 ± 1.43）。无论软组织厚度如何，差异均具有统计学意义。氧化锆基台获得的PES值最高（10.88 ± 0.88），其次是粉色阳极氧化钛基台（10.12 ± 1.13），灰色钛基台最低（9.68 ± 1.41）。仅在薄软组织组中，PES差异具有统计学意义。关于患者满意度，对于每个问题，粉色阳极氧化和氧化锆混合基台组的VAS评分均高于灰色钛基台组。
无论组织厚度如何，所有组中牙齿和种植体周围软组织之间的颜色差异均显著。混合氧化锆基台导致的颜色差异最小，其次是粉色阳极氧化钛基台和灰色钛基台。仅在薄组织组中记录到显著不同的PES值。在1年随访时，氧化锆基台和粉色阳极氧化基台之间的患者满意度无显著差异。粉色阳极氧化基台是氧化锆混合基台的良好美学替代方案，尤其是在机械挑战性较大的情况下。
