Koster Maysa, Dias Debora R, Zimiani Gabriela de S, Santos Rafael P da M, de Oliveira Ricardo P, Araújo Maurício G, Hayacibara Roberto M
Department of Dentistry, State University of Maringá, Maringá, Brazil.
Department of Statistics, State University of Maringá, Maringá, Brazil.
Clin Oral Implants Res. 2023 Dec;34(12):1438-1449. doi: 10.1111/clr.14175. Epub 2023 Sep 7.
This retrospective case series aimed to assess the stability of the papilla around four single crowns supported by narrow-diameter implants replacing all maxillary incisors. Secondary objectives included assessment of marginal bone level stability, incidence of technical and biological complications, and patient satisfaction.
Individuals with four adjacent implants in maxillary incisor sites, placed with a 3 mm inter-implant distance and rehabilitated with single crowns were included. Retrospective data were obtained from photographs and radiographs taken at the delivery of the prosthesis (baseline-T0). Patients were then recalled (≥2 years after T0) for clinical and radiographic examination (follow-up-T1). Photographs were obtained and patient satisfaction was assessed using a visual analogue scale. Papilla height and marginal bone level were compared over time.
Data from 10 patients with medium-low smile lines and rehabilitated with 40 implants, in function for 5.4 ± 1.9 years, were analyzed. The papilla height between implants (T0: 2.3 ± 0.9 mm; T1: 2.6 ± 0.7 mm; p = .011) and between tooth and implant (T0: 3.4 ± 0.9 mm; T1: 3.8 ± 0.8 mm; p = .025) increased significantly over the years. The marginal bone level remained stable over time (T0: 0.88 ± 0.57 mm; T1: 0.71 ± 0.67 mm; p = .007). Patients were highly satisfied (97.7 ± 0.3%) with the treatment outcome.
Within its limitations, this study demonstrated that four single implant-supported crowns placed at maxillary incisor sites may exhibit soft tissue and marginal bone stability over a long period of time. This treatment approach, however, should be restricted to few patients as it requires a proper case selection and skillful execution of all surgical and prosthetic steps.
本回顾性病例系列旨在评估上颌切牙全部被窄直径种植体支持的四颗单冠周围乳头的稳定性。次要目标包括评估边缘骨水平稳定性、技术和生物学并发症的发生率以及患者满意度。
纳入上颌切牙部位有四颗相邻种植体、种植体间距离为3毫米且用单冠修复的个体。回顾性数据来自义齿交付时（基线-T0）拍摄的照片和X光片。然后召回患者（T0后≥2年）进行临床和影像学检查（随访-T1）。获取照片并使用视觉模拟量表评估患者满意度。随时间比较乳头高度和边缘骨水平。
分析了10例中低微笑线且用40颗种植体修复、使用功能为5.4±1.9年的患者的数据。种植体之间的乳头高度（T0：2.3±0.9毫米；T1：2.6±0.7毫米；p = 0.011）以及牙齿与种植体之间的乳头高度（T0：3.4±0.9毫米；T1：3.8±0.8毫米；p = 0.025）多年来显著增加。边缘骨水平随时间保持稳定（T0：0.88±0.57毫米；T1：0.71±0.67毫米；p = 0.007）。患者对治疗结果高度满意（97.7±0.3%）。
在其局限性范围内，本研究表明上颌切牙部位放置的四颗单种植体支持的牙冠可能在很长一段时间内表现出软组织和边缘骨的稳定性。然而，这种治疗方法应仅限于少数患者，因为它需要适当的病例选择以及所有手术和修复步骤的熟练执行。
