Bagnasco Francesco, Menini Maria, Pesce Paolo, Gibello Umberto, Carossa Massimo, Pera Francesco
Department of Surgical Sciences (DISC), Division of Prosthodontics and Implant Prosthodontics Dentistry, University of Genoa, Genoa, Italy.
C.I.R. Dental School, Department of Surgical Sciences, University of Turin, Turin, Italy.
Clin Implant Dent Relat Res. 2025 Feb;27(1):e13416. doi: 10.1111/cid.13416. Epub 2024 Nov 6.
Full-arch immediate loading rehabilitations are now a widely used rehabilitation method that guarantees predictable medium- and long-term results. Numerous factors can influence its success and stability in the medium and long term. Among these the implant-abutment connection seems to play an important role, however there is still little information on which is the most suitable in this type of treatment.
The aim of the present multicenter split-mouth controlled trial is to evaluate whether external hexagonal connections (EHC) and internal hexagonal connections (IHC) can influence success, bone resorption and peri-implant parameters in immediate-load full-arch rehabilitations.
Twenty patients were rehabilitated with immediately loaded fixed full-arch rehabilitations. All the implants presented the same macro- and micro-topography but different implant-abutment connection. IHC were used in one randomly selected side of the jaw and EHC was used in the other side. Outcome measures were implant survival rate, peri-implant marginal bone loss (MBL), plaque index (PI), probing depth (PD), and bleeding on probing (BoP) evaluated at 3, 6, 12, 36, and 72-month post-loading. Technical and biological complications were recorded.
In 20 patients, 43 EHC and 40 IHC implants were placed. Between 32 and 72 months of follow-up two patients withdrew (died) and no implants were lost. The cumulative survival rate (CSR) was 97.44% for EHC implants and 97.22% for IHC implants. The MBL presented a resorption of 2 mm in the EHC group and 1.9 mm in the IHC group. No statistically significant differences were found between the two groups for any of the parameters at any time. No biological or technical complications were detected between the 36th and 72nd month of follow-up.
After 72 months in function, both internal and external hexagon connections provided good clinical outcomes and were not associated with any significant difference in the clinical outcomes.
全牙弓即刻负重修复是一种广泛应用的修复方法，能保证可预测的中长期效果。许多因素会影响其在中长期的成功与稳定性。其中，种植体-基台连接似乎起着重要作用，然而对于这类治疗中哪种连接最合适仍知之甚少。
本多中心双侧对照试验旨在评估外六角连接（EHC）和内六角连接（IHC）在即刻负重全牙弓修复中是否会影响成功率、骨吸收及种植体周围参数。
20例患者接受即刻负重固定全牙弓修复。所有种植体具有相同的宏观和微观形貌，但种植体-基台连接不同。在颌骨一侧随机选择使用IHC，另一侧使用EHC。观察指标为负重后3、6、12、36和72个月时评估的种植体存活率、种植体周围边缘骨丢失（MBL）、菌斑指数（PI）、探诊深度（PD）和探诊出血（BoP）。记录技术和生物学并发症。
20例患者共植入43枚EHC种植体和40枚IHC种植体。随访32至72个月期间，2例患者退出（死亡），无种植体丢失。EHC种植体的累积存活率（CSR）为97.44%，IHC种植体为97.22%。EHC组MBL吸收2mm，IHC组为1.9mm。两组在任何时间的任何参数之间均未发现统计学显著差异。随访第36至72个月期间未检测到生物学或技术并发症。
使用72个月后，内六角和外六角连接均提供了良好的临床效果，且临床效果无显著差异。
