Spinelli Andrea, Zamparini Fausto, Romanos Georgios, Gandolfi Maria Giovanna, Prati Carlo
Endodontic Clinical Section, Department of Biomedical and Neuromotor Sciences, School of Dentistry, University of Bologna, 40125 Bologna, Italy.
Laboratory of Biomaterials and Oral Pathology, Department of Biomedical and Neuromotor Sciences, School of Dentistry, University of Bologna, 40125 Bologna, Italy.
Materials (Basel). 2023 Feb 2;16(3):1293. doi: 10.3390/ma16031293.
The present study aims to analyze the use of Laser-Lok microtextured neck implants placed with a transmucosal surgical approach. The marginal bone level (MBL) and periodontal parameters were evaluated in a cohort prospective 4-year clinical study.
A total of 41 implants were placed in 36 healthy consecutive patients (16 males, 20 females, mean age 60 ± 9 years). Tapered tissue level implants, characterized by a 2.0 mm laser-microtextured neck, were used with a flapless approach. Customized abutments and provisional resin crowns were positioned. Definitive metal-ceramic crowns were cemented approximately 4 months after insertion. Periapical radiographs were taken after 1, 3, 6, 12, 36 and 48 months from implant placement to evaluate MBL. Gingival thickness (thin/thick), plaque score (PS) and bleeding on probing (BoP) were evaluated.
After 48 months, all implants were safe from complications. No complications, peri-implantitis, early implant failures or mucositis occurred. The survival rate was 100%. Mean MBL during the follow-up was -0.15 ± 0.18 at T1, -0.29 ± 0.29 at T3, -0.45 ± 0.37 at T6, -0.53 ± 0.45 at T12, -1.06 ± 1.13 at T 36 and -1.10 ± 0.89 at T 48. Implants placed 2-3 months after tooth extraction revealed lower MBL variation when compared to those placed immediately (in fresh extraction sockets) or in completely healed ridges (delayed group). Narrower diameter implants (3.8 mm) showed significantly higher MBL variation when compared to 4.6 diameter implants. Multilevel analysis at T48 revealed that among all the evaluated variables, implant diameter was the factor mostly associated with MBL modifications ( = 0.027).
This 4-year clinical study supports the use of Laser-Lok implants placed at tissue level with a flapless approach. A limited bone loss during the 48-month follow-up was observed. Periodontal parameters were stable with no sign of inflammation or soft tissue alteration. The use of Laser-Lok implants with transmucosal surgery represents a suitable technique with a minimally invasive approach.
本研究旨在分析采用经黏膜手术入路植入Laser-Lok微纹理颈部种植体的情况。在一项前瞻性队列4年临床研究中评估了边缘骨水平（MBL）和牙周参数。
共为36例连续的健康患者（16例男性，20例女性，平均年龄60±9岁）植入41枚种植体。使用具有2.0 mm激光微纹理颈部的锥形组织水平种植体，并采用不翻瓣手术入路。安装定制基台和临时树脂冠。植入后约4个月粘结最终的金属烤瓷冠。在种植体植入后1、3、6、12、36和48个月拍摄根尖片以评估MBL。评估牙龈厚度（薄/厚）、菌斑评分（PS）和探诊出血（BoP）。
48个月后，所有种植体均无并发症。未发生并发症、种植体周围炎、早期种植体失败或黏膜炎。生存率为100%。随访期间的平均MBL在T1时为-0.15±0.18，T3时为-0.29±0.29，T6时为-0.45±0.37，T12时为-0.53±0.45，T36时为-1.06±1.13，T48时为-1.10±0.89。与立即植入（在新鲜拔牙窝）或在完全愈合的牙槽嵴中植入（延迟组）的种植体相比，拔牙后2-3个月植入的种植体MBL变化较小。与直径4.6 mm的种植体相比，直径较窄（3.8 mm）的种植体MBL变化显著更高。T48时的多水平分析显示，在所有评估变量中，种植体直径是与MBL改变最相关的因素（P = 0.027）。
这项4年临床研究支持采用不翻瓣手术入路在组织水平植入Laser-Lok种植体。在48个月的随访期间观察到有限的骨吸收。牙周参数稳定，无炎症或软组织改变迹象。经黏膜手术使用Laser-Lok种植体是一种合适的微创技术。
