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使用同种异体骨材料移植和不移植进行内窦底抬高植入物放置的植入物稳定性和临床结果:一项为期 1 年的随机临床试验。

Implant stability and clinical outcome between implant placement using internal sinus floor elevation with alloplastic bone material grafting and without grafting: A 1-year randomized clinical trial.

机构信息

Center of Excellence for Dental Implantology, Faculty of Dentistry, Chiang Mai University, T. Suthep, A. Muang, Chiang Mai, 50200, Thailand.

出版信息

Clin Oral Investig. 2024 May 27;28(6):342. doi: 10.1007/s00784-024-05736-w.

Abstract

OBJECTIVE

To compare implant stability and clinical outcome in implant placement between osteotome sinus floor elevation (OSFE) with biphasic calcium phosphate (BCP) which consisted of 30% of hydroxyapatite (HA) and 70% of beta-tricalcium phosphate (β -TCP) grafting material and OSFE without using bone grafting material. The research questions is whether the BCP provides any benefit in OSFE or not.

MATERIALS AND METHODS

Thirty patients (30 implants) with a single edentulous area of upper premolar or molar were randomly separated into OSFE with BCP (n = 15) and OSFE without grafting (n = 15). The patients were reevaluated 3, 6, 9, and 12 months after implant loading. The clinical assessments (implant stability quotient (ISQ), implant survival-failure rate, and surgical complication) were analyzed. Together with radiographic assessments in 2D (endo-sinus bone gain (ESBG), mean marginal bone change (MMBC)) and 3D (endo-sinus bone gain in CBCT (ESBG-CT)) were evaluated, with a mean follow-up time of at least 12 months of functional loading and prosthetic complication.

RESULTS

20 remaining implants (OSFE with BCP, n = 10; OSFE without grafting, n = 10) were analyzed. Mean ISQ was 79.18 3.43 in 1-year follow-up (ISQ; OSFE with BCP = 78.72 3.46, OSFE without grafting = 79.65 3.52). ISQ in both groups increased steadily without significant differences in each follow-up. (p = 0.56). In radiographic evaluation, at 6-, 9-, and 12-month, OSFE without grafting group showed statistically significant lower MMBC (p < 0.05). The 1-year clinical results showed that 2 implants failed in OSFE with BCP, and 1 implant failed in OSFE without grafting.

CONCLUSIONS

Graft material "BCP" (HA30:TCP70) coupled with OSFE presents no extraordinary benefit in implant stability, clinical and radiographic outcome in 1-year follow-up.

CLINICAL RELEVANCE

Clinically, OSFE with grafting materials provides no additional benefit.

CLINICAL TRIAL REGISTRATION NUMBER

TCTR20210517008 (date of registration: May 17, 2021).

摘要

目的

比较使用骨凿上颌窦底提升术(OSFE)联合应用双相磷酸钙(BCP)[由 30%的羟基磷灰石(HA)和 70%的β-磷酸三钙(β-TCP)组成]与不使用骨移植材料的 OSFE 对种植体稳定性和临床结果的影响。研究问题是 BCP 是否对 OSFE 有任何益处。

材料和方法

30 名患者(30 枚种植体)上颌前磨牙或磨牙单个缺牙区,随机分为 OSFE 联合 BCP 组(n=15)和 OSFE 不使用移植材料组(n=15)。在种植体负重后 3、6、9 和 12 个月进行再次评估。分析临床评估(种植体稳定性指数(ISQ)、种植体存活/失败率和手术并发症)。结合二维(窦内骨增量(ESBG)、平均边缘骨变化(MMBC))和三维(CBCT 窦内骨增量(ESBG-CT))的放射学评估,平均随访时间至少为 12 个月的功能负荷和修复体并发症。

结果

20 枚剩余种植体(OSFE 联合 BCP,n=10;OSFE 不使用移植材料,n=10)进行了分析。1 年随访时平均 ISQ 为 79.18 3.43(ISQ;OSFE 联合 BCP=78.72 3.46,OSFE 不使用移植材料=79.65 3.52)。两组的 ISQ 均呈稳步上升趋势,各随访时间点无显著差异(p=0.56)。在放射学评估中,在 6、9 和 12 个月时,OSFE 不使用移植材料组的 MMBC 统计学上显著降低(p<0.05)。1 年临床结果显示,OSFE 联合 BCP 组有 2 枚种植体失败,OSFE 不使用移植材料组有 1 枚种植体失败。

结论

在 1 年的随访中,使用骨凿上颌窦底提升术联合应用骨移植材料“BCP”(HA30:TCP70)并没有在种植体稳定性、临床和放射学结果方面带来额外的益处。

临床相关性

临床上,使用移植材料的 OSFE 并没有带来额外的益处。

临床试验注册号

TCTR20210517008(注册日期:2021 年 5 月 17 日)。

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