Department of Prosthetic Dentistry, School of Dental Medicine, Philipps-University Marburg/Lahn, Georg-Voigt Str. 3, 35039, Marburg, Lahn, Germany.
moreDATA GmbH, Gießen Kerkrader Strasse 11, 35394, Gießen, Germany.
Int J Implant Dent. 2024 Aug 13;10(1):39. doi: 10.1186/s40729-024-00531-4.
The aim of this long-term cohort study in periodontally compromised patients with implants was to analyze the correlation between gingival phenotype and peri-implant crestal bone loss, and between clinical measures and gingival phenotype.
Implant-supported single crowns and bridges were used to rehabilitate 162 implants in 57 patients. Patients were examined over a 2 to 20-year period on a recall schedule of 3 to 6 months. In addition to recording clinical parameters, intraoral radiographs were taken at baseline (immediately after superstructure insertion) and at 1, 3, 5, 10, 15, and 20 years. Patients were differentiated into phenotype 1 with thin, scalloped gingiva and narrow attached gingiva (n = 19), phenotype 2 with thick, flat gingiva and wide attached gingiva (n = 23), or phenotyp 3 with thick, scalloped gingiva and narrow attached gingiva (n = 15).
The mean peri-implant crestal bone loss during the first 12 months was 1.3 ± 0.7 mm. Patients with gingival phenotype 1 had a significantly greater rate of increased crestal bone loss at implants (p = 0.016). No significant differences were present in subsequent years. The prevalence of mucositis at all implants was 27.2%, and the prevalence of peri-implantitis 9.3%. Univariate analyses indicated a significantly higher peri-implantitis risk in patients with gingival phenotype 2 (p-OR = 0.001; p-OR = 0.020). The implants of patients with phenotype 2 had significantly greater probing depths (1st year p < 0.001; 3rd year p = 0.016; 10th year p = 0.027; 15th year p < 0.001). Patients with gingival phenotype 3 showed no significantly increased probing depths, signs of inflammation and crestal bone loss.
Patients with a gingival phenotype 1 have greater crestal bone loss at implants during the first year of functional loading. Patients with gingival phenotype 2 had significantly greater probing depth at implants and risk of peri-implantitis.
本项长期队列研究旨在分析牙周病患者种植体周围龈缘形态与种植体边缘骨丧失的相关性，以及临床指标与龈缘形态的相关性。
使用种植体支持的单冠和固定桥修复了 57 名患者的 162 个种植体。患者在 2 至 20 年的随访期内，每 3 至 6 个月接受一次检查。除了记录临床参数外，还在基线（上部结构插入后立即）和 1、3、5、10、15 和 20 年时拍摄口腔内的放射照片。根据龈缘形态，患者被分为 1 型（薄而呈扇贝形的龈缘，附着龈较窄）（n=19）、2 型（厚而平坦的龈缘，附着龈较宽）（n=23）或 3 型（厚而呈扇贝形的龈缘，附着龈较窄）（n=15）。
在最初的 12 个月内，种植体边缘骨的平均丧失量为 1.3±0.7mm。龈缘形态 1 型的患者，种植体边缘骨的增加量显著更大（p=0.016）。在随后的几年中，没有出现显著差异。所有种植体的黏膜炎发生率为 27.2%，而种植体周围炎的发生率为 9.3%。单因素分析表明，龈缘形态 2 型的患者发生种植体周围炎的风险显著更高（p-OR=0.001；p-OR=0.020）。龈缘形态 2 型患者的种植体具有显著更大的探诊深度（第 1 年 p<0.001；第 3 年 p=0.016；第 10 年 p=0.027；第 15 年 p<0.001）。龈缘形态 3 型的患者，探诊深度、炎症和边缘骨丧失均无显著增加。
在功能负荷的最初 1 年内，龈缘形态 1 型的患者种植体边缘骨丧失更大。龈缘形态 2 型的患者，种植体的探诊深度更大，且发生种植体周围炎的风险更高。
