Stoilov Milan, Winterhoff Joerg, Stoilov Lea, Timoschenko Anastasia, Stark Helmut, Heuser Florian, Marder Michael, Kraus Dominik, Enkling Norbert
Department of Prosthodontics, Preclinical Education and Dental Materials Science, University Hospital Bonn, 53111 Bonn, Germany.
Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3012 Bern, Switzerland.
J Funct Biomater. 2025 Mar 8;16(3):93. doi: 10.3390/jfb16030093.
(1) Background: Early-stage bone resorption following implant placement can significantly impact the long-term success of implants. This study evaluates whether a fully digitally planned implant position based on the E-point concept, along with guided profiling of the supracrestal complex, contributes to improved stability of peri-implant bone levels. (2) Methods: 29 implants were placed in 27 patients utilizing both immediate (Group 1; n = 19) and delayed placement (Group 2; n = 10) protocols. Implant position and emergence profile were preoperatively determined and consistently executed through guided surgery and CAD/CAM-fabricated restorations. Due to the subcrestal positioning of the implant, a corresponding bone profiler with a guide pin was used to shape the emergence profile and prevent the provisional restoration from impinging on the proximal bone. Provisional restorations were immediately placed to support the emergence profile. Bone level changes were documented radiographically over a two-year period. The first Bone-to-Implant Contact Level (∆ fBIC), change in highest approximal Bone Level (∆ haBL), and formation of an emergence profile width (WEP) were measured. (3) Results: All implants and restorations survived after two years, no significant change in first Bone-to-Implant Contact Level (∆ fBIC = 0 ± 0.02 mm), no change in highest approximal Bone Level (∆ haBL) of -0.23 mm ± 0.71 mm, and formation of an emergence profile width (WEP) averaging 0.18 ± 0.19 mm. (4) Conclusions: Despite the initial stress on the bone caused by bone profiling, guided implant placement and bone shaping, supported by an immediate provisional, have a positive effect on peri-implant bone stability.
(1) 背景：种植体植入后的早期骨吸收会显著影响种植体的长期成功率。本研究评估基于E点概念的完全数字化规划种植体位置，以及龈上复合体的引导式塑形，是否有助于改善种植体周围骨水平的稳定性。(2) 方法：在27例患者中植入29颗种植体，采用即刻种植（第1组；n = 19）和延期种植（第2组；n = 10）方案。术前确定种植体位置和穿出轮廓，并通过引导手术和计算机辅助设计/计算机辅助制造（CAD/CAM）制作的修复体持续执行。由于种植体位于龈下，使用带有导向销的相应骨成型器来塑形穿出轮廓，并防止临时修复体压迫近端骨。立即放置临时修复体以支持穿出轮廓。在两年时间内通过影像学记录骨水平变化。测量首次骨与种植体接触水平（∆fBIC）、最高邻面骨水平变化（∆haBL）和穿出轮廓宽度（WEP）的形成情况。(3) 结果：两年后所有种植体和修复体均存活，首次骨与种植体接触水平无显著变化（∆fBIC = 0 ± 0.02 mm），最高邻面骨水平变化为-0.23 mm ± 0.71 mm，穿出轮廓宽度（WEP）平均为0.18 ± 0.19 mm。(4) 结论：尽管骨塑形对骨造成了初始应力，但在即刻临时修复体的支持下，引导式种植体植入和骨塑形对种植体周围骨稳定性有积极影响。
