Private practice, VIC Clinic, Vivulskio 7, Vilnius LT 01362, Lithuania.
Private practice, VIC Clinic, Vivulskio 7, Vilnius LT 01362, Lithuania; Faculty of Dentistry, Lithuania University of Health Science, Kaunas, Lithuania.
J Dent. 2024 Sep;148:105224. doi: 10.1016/j.jdent.2024.105224. Epub 2024 Jun 30.
To evaluate the 10-year influence of soft tissue height (STH) on crestal bone level changes (CBC) in bone-level implants with non-matching internal conical connections.
MATERIAL & METHODS: From the initial 97 patients, 59 (19 men, 40 women, age 55.86 ± 9.5 years) returned for the recall visit. Based on baseline STH, they were categorized into T1 (thin STH ≤2 mm, n = 33), T2 (thin STH augmented with allogenic tissue matrix (ATM), n = 32), and C (thick STH >2 mm, n = 32). Implants were placed in the posterior mandible using a one-stage approach and received single screw-retained restorations. Clinical (PPD, BOP, PI) and radiographic examinations were conducted after 10 years, with CBC calculated mesial and distal to each implant.
After 10 years, implants in surgically thickened (T2) or naturally thick STH (C) showed bone gains of 0.57 ± 0.55 mm and 0.56 ± 0.40 mm, respectively (p < 0.0001) shifting from an initial CBC of -0.21 ± 0.33 mm to 0.36 ± 0.29 mm in the thick STH group and -0.2 ± 0.35 mm to 0.37 ± 0.29 mm in the surgically thickened STH group. Implants in naturally thin STH yielded a non-significant trend of bone loss (-0.12 ± 0.41 mm; p > 0.05).
Implants in thin STH (≤2 mm) exhibited greater CBC over the study period. Significant bone gains were observed in thick STH cases, indicating that naturally thick STH or STH augmentation with ATM may contribute to maintain CBC in long-term around implants.
This is the first long-term follow-up study suggesting that adequate soft tissue height around implants helps maintain stable peri‑implant bone levels. While tissue thickness plays a key role, other factors also interact with peri‑implant tissue height to sustain crestal bone stability over time.
评估非匹配内锥形连接骨水平种植体中软组织高度（STH）对嵴顶骨水平变化（CBC）的 10 年影响。
从最初的 97 名患者中，有 59 名（19 名男性，40 名女性，年龄 55.86±9.5 岁）返回进行召回检查。根据基线 STH，他们被分为 T1（薄 STH≤2mm，n=33）、T2（薄 STH 用同种异体组织基质（ATM）增强，n=32）和 C（厚 STH>2mm，n=32）。使用一期手术方法将种植体放置在下颌后区，并接受单螺丝固位修复体。在 10 年后进行临床（PPD、BOP、PI）和影像学检查，计算每个种植体近中和远中侧的 CBC。
在 10 年后，在手术增厚（T2）或自然增厚 STH（C）的种植体中，分别获得了 0.57±0.55mm 和 0.56±0.40mm 的骨增量（p<0.0001），从初始 CBC 的-0.21±0.33mm 分别转移到增厚 STH 组的 0.36±0.29mm 和手术增厚 STH 组的 0.37±0.29mm。自然薄 STH 中的种植体呈现出非显著的骨损失趋势（-0.12±0.41mm；p>0.05）。
在研究期间，薄 STH（≤2mm）中的种植体表现出更大的 CBC。在厚 STH 病例中观察到显著的骨增益，表明自然厚 STH 或用 ATM 增强 STH 可能有助于维持种植体周围的长期 CBC。
这是第一项长期随访研究，表明种植体周围足够的软组织高度有助于维持稳定的种植体周围骨水平。虽然组织厚度起着关键作用，但其他因素也与种植体周围组织高度相互作用，以维持嵴顶骨的稳定性随时间推移。
