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延期和即刻种植修复负重6个月后边缘骨水平和骨厚度减少情况:一项临床前瞻性观察研究

Marginal Bone Level and Bone Thickness Reduction in Delayed and Immediate Implant Placement Protocol 6 Months Post-loading: An Observational Clinical Prospective Study.

作者信息

Dagher Maroun, Mokbel Nadim, Aboukhalil Rami, Ghosn Nabil, Kassir Abdelrahman, Naaman Nada

机构信息

Department of Periodontology, Faculty of Dental Medicine, Saint Joseph University, Riad el Solh, P. O. Box: 11-5076, Beirut, 11072050 Lebanon.

Department of Radiology, Faculty of Dental Medicine, Saint Joseph University, Beirut, Lebanon.

出版信息

J Maxillofac Oral Surg. 2022 Jun;21(2):571-579. doi: 10.1007/s12663-021-01673-3. Epub 2022 Jan 7.

Abstract

OBJECTIVES

The aim of this prospective study was to assess marginal bone level (MBL), buccal and palatal bone thickness reduction (BTR) around implants in delayed and immediate placement protocols, 6 months after loading.

MATERIALS AND METHODS

Twenty-four patients were assigned to two treatment groups, and treated with an immediate (Test) or delayed implant placement (Control). Baseline and 6 months post-loading periapical and Cone Beam Computed Tomography radiographs were used to measure mesial, distal, buccal, and palatal MBL change, and buccal and palatal BTR.

RESULTS

There was no statistically significant difference between groups, in MBL change, mesially ( = 0.4220), distally ( = 0.774), buccally ( = 0.221), and palatally ( = 0.195). There was more MBL change on the buccal side than on the palatal side in both groups, control ( = 0.012) and test ( = 0.005). Buccal bone thickness decreased significantly in both groups, and at all four levels ( < 0.05). Buccal BTR was higher in test implants at 0, 2, and 4 mm ( = 0.005, = 0.0018, = 0.006) on the buccal side, and at 0 mm ( = 0.006) on the palatal side. Implant stability increased in both groups ( < 0.001). A positive correlation was found between insertion torque and stability in the control group ( = 0.024).

CONCLUSIONS

Within the study limitations, MBL changes occur around implants and are comparable between groups. More buccal than palatal MBL change occurs in both groups. Buccal BTR is higher in immediate cases. Implant stability augmented in both groups.

CLINICAL RELEVANCE

This data call for additive therapy to compensate for the expected bone loss, particularly in esthetically demanding cases.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT04346706 Registered 14 April 2020 - Retrospectively registered, http://www.clinicalTrials.gov.

摘要

目的

本前瞻性研究的目的是评估在加载6个月后,延期和即刻种植方案中种植体周围的边缘骨水平(MBL)、颊侧和腭侧骨厚度减少(BTR)情况。

材料与方法

24例患者被分为两个治疗组,分别接受即刻种植(试验组)或延期种植(对照组)治疗。使用基线及加载后6个月的根尖片和锥形束计算机断层扫描(CBCT)影像来测量近中、远中、颊侧和腭侧的MBL变化以及颊侧和腭侧的BTR。

结果

两组之间在近中(P = 0.4220)、远中(P = 0.774)、颊侧(P = 0.221)和腭侧(P = 0.195)的MBL变化方面无统计学显著差异。在对照组(P = 0.012)和试验组(P = 0.005)中,颊侧的MBL变化均多于腭侧。两组在所有四个水平上颊侧骨厚度均显著降低(P < 0.05)。试验组种植体在颊侧0、2和4 mm处(P = 0.005、P = 0.0018、P = 0.006)以及腭侧0 mm处(P = 0.006)的颊侧BTR更高。两组种植体稳定性均增加(P < 0.001)。对照组中植入扭矩与稳定性之间存在正相关(P = 0.024)。

结论

在本研究局限性范围内,种植体周围会发生MBL变化,且两组间具有可比性。两组中颊侧的MBL变化均多于腭侧。即刻种植病例的颊侧BTR更高。两组种植体稳定性均增强。

临床意义

这些数据表明需要采用附加治疗来补偿预期的骨丢失,尤其是在对美观要求较高的病例中。

试验注册

ClinicalTrials.gov标识符:NCT04346706,于2020年4月14日注册——回顾性注册,http://www.clinicalTrials.gov

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