Kim Donghyun, Kim Kihyun, Ohe Joo-Young, Song Seung Jun, Paek Janghyun
Graduate student, Department of Dentistry, Graduate School, Kyung Hee University, Seoul, Republic of Korea.
Resident, Section of Orthodontics, School of Dentistry, University of California, Los Angeles (UCLA), Los Angeles, CA.
J Prosthet Dent. 2025 Jan;133(1):162.e1-162.e7. doi: 10.1016/j.prosdent.2024.09.015. Epub 2024 Oct 29.
The effects of nonaxial forces on peri-implant bone loss have been investigated, mostly in reference to buccal mesiodistal implant angulations as potential risk indicators. However, when implant angulations are multidirectional, including the buccolingual aspect, evaluations of peri-implant bone loss based solely on mesiodistal measurements may skew the correlation.
The purpose of this retrospective study was to evaluate the correlation between the magnitudes of multidirectional implant angulations and peri-implant crestal bone loss.
Data were retrospectively collected and analyzed from clinical records, periapical radiographic images, and computer-aided design (CAD) files of custom abutments. The study included 288 patients with 506 dental implants, and the mean follow-up duration after the placement of definitive prostheses was 5.1 years. Patients with uncontrolled systemic disease were excluded. Variables such as age, sex, type of unit (single-unit or multi-unit), location (maxillary or mandibular and anterior, premolar, or molar), and antagonist (natural tooth, implant-supported prosthesis, or removable prosthesis) were evaluated. The angulation of the implant (mesiodistal and buccolingual) and status of attrition (normal, localized, or generalized) were assessed using the CAD file. The angulation of the implant was then derived from the mesiodistal and buccolingual angle measurements by using a mathematical formula. Peri-implant bone loss was measured from periapical radiographs. A comparison of peri-implant bone loss between axial and nonaxial implants was performed using the Student t test (α=.05). Additional comparative evaluations were performed according to the type of unit, location, antagonist, and status of attrition in reference to the angulation categories.
The mean ±standard deviation peri-implant bone loss over 5 years was 0.10 ±0.39 mm in the axial implants and 0.22 ±0.48 mm in the nonaxial implants. Statistical analysis showed that nonaxial implants had a significantly greater bone loss (P<.05), which was more pronounced when the antagonists were implant-supported prostheses (P<.05) and when the implants were located in the mandible (P<.05).
A significant correlation was observed between implant angulation and peri-implant bone loss. Nonaxially positioned implants exhibited greater bone loss compared with axially positioned implants. Additionally, the location of the implant and the type of antagonist were found to influence the extent of bone loss. These findings suggest that careful consideration of implant angulation, as well as the position and type of antagonist, is crucial in minimizing peri-implant bone loss.
已对非轴向力对种植体周围骨丢失的影响进行了研究，主要涉及颊侧近远中种植体角度作为潜在风险指标。然而，当种植体角度为多方向时，包括颊舌侧方向，仅基于近远中测量来评估种植体周围骨丢失可能会使相关性出现偏差。
本回顾性研究的目的是评估多方向种植体角度大小与种植体周围嵴顶骨丢失之间的相关性。
从临床记录、根尖片影像以及定制基台的计算机辅助设计（CAD）文件中回顾性收集并分析数据。该研究纳入了288例患者的506颗牙种植体，最终修复体植入后的平均随访时间为5.1年。排除患有未控制的全身性疾病的患者。对年龄、性别、单位类型（单单位或多单位）、位置（上颌或下颌以及前部、前磨牙或磨牙）和对颌牙（天然牙、种植体支持的修复体或可摘修复体）等变量进行评估。使用CAD文件评估种植体的角度（近远中及颊舌侧）和磨耗状态（正常、局部或普遍）。然后通过数学公式从近远中角度和颊舌侧角度测量值得出种植体角度。从根尖片中测量种植体周围骨丢失情况。使用Student t检验（α = 0.05）对轴向和非轴向种植体之间的种植体周围骨丢失进行比较。根据单位类型、位置、对颌牙和磨耗状态在角度类别方面进行额外的比较评估。
轴向种植体5年期间种植体周围骨丢失的平均值±标准差为0.10±0.39mm，非轴向种植体为0.22±0.48mm。统计分析表明，非轴向种植体的骨丢失明显更多（P < 0.05），当对颌牙为种植体支持的修复体时（P < 0.05）以及种植体位于下颌时（P < 0.05）这种情况更明显。
观察到种植体角度与种植体周围骨丢失之间存在显著相关性。与轴向定位的种植体相比，非轴向定位的种植体表现出更大的骨丢失。此外，发现种植体的位置和对颌牙的类型会影响骨丢失的程度。这些发现表明，在最小化种植体周围骨丢失方面，仔细考虑种植体角度以及对颌牙的位置和类型至关重要。
