Barwacz Christopher A, Swenson Madeline, Couso-Queiruga Emilio, Comnick Carissa, Xie Xian Jin, Avila-Ortiz Gustavo
Department of Family Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USA.
Private Practice, West Des Moines, Iowa, USA.
Clin Oral Implants Res. 2025 Mar;36(3):374-385. doi: 10.1111/clr.14389. Epub 2024 Dec 6.
Variations in transmucosal abutment contour design may affect the outcomes of implant therapy. This randomized controlled trial was primarily aimed at testing the effect that CAD/CAM zirconia abutments with either a concave or linear divergent transmucosal morphology have on peri-implant mucosal dynamics and indicators of peri-implant health at 1 year after final implant-supported prosthesis insertion in the anterior maxilla.
Following computer-guided implant placement and osseointegration, eligible subjects were randomized into either the experimental (concave morphology) or the control (linear divergent morphology) group. A comprehensive set of outcomes of interest related to peri-implant soft tissue dynamics, phenotypical features, and indicators of peri-implant health were assessed at different time points over a 1-year period after insertion of the final restoration.
Out of 60 initially recruited subjects, a total of 54 completed the study (n = 29 in the experimental group concave/n = 25 in the control group). Overall implant survival and restoration rates between master impression and 12 months were 100% and 98.2%, respectively. Although a trend for coronal migration of the buccal mucosa zenith, gain in mucosal thickness, and increased probing depth and bleeding on probing was observed in both groups, these changes were clinically negligible, and no substantial differences were observed between study groups regardless of variations in transmucosal abutment morphology.
The use of either linear divergent or concave custom CAD/CAM zirconia abutments in a screw-retained, delayed loading approach yielded no significant differences.
穿黏膜基台轮廓设计的变化可能会影响种植治疗的效果。这项随机对照试验的主要目的是测试在前上颌骨最终植入种植体支持的修复体后1年，具有凹形或线性发散穿黏膜形态的计算机辅助设计/计算机辅助制造（CAD/CAM）氧化锆基台对种植体周围黏膜动态变化和种植体周围健康指标的影响。
在计算机引导下植入种植体并实现骨结合后，符合条件的受试者被随机分为试验组（凹形形态）或对照组（线性发散形态）。在最终修复体植入后的1年时间内，在不同时间点评估了一系列与种植体周围软组织动态变化、表型特征以及种植体周围健康指标相关的感兴趣的结果。
在最初招募的60名受试者中，共有54名完成了研究（试验组凹形n = 29/对照组n = 25）。从制取主模型印模到12个月期间，种植体的总体存活率和修复率分别为100%和98.2%。尽管两组均观察到颊侧黏膜顶点有向冠方迁移趋势、黏膜厚度增加、探诊深度增加以及探诊出血，但这些变化在临床上可忽略不计，且无论穿黏膜基台形态如何变化，研究组之间均未观察到实质性差异。
在采用螺丝固位、延期加载的方法中，使用线性发散或凹形定制CAD/CAM氧化锆基台没有显著差异。
