在一项为期3年的随机对照临床试验中，在现有的可摘局部义齿下植入微型种植体可降低余留牙的松动度。
Mini-implant placement under existing removable partial dentures decreased the mobility of remaining teeth in a randomized controlled 3-year clinical trial.
作者信息
Mundt Torsten, Jaghsi Ahmad Al, Heinemann Friedhelm, Schwahn Christian
机构信息
Department of Prosthodontics, Gerodontology and Dental Materials, University Medicine of Greifswald, Walther-Rathenau-Str. 42a, Greifswald, D-17475, Germany.
College of Dentistry, Clinical Sciences Department, Ajman University, Ajman, United Arab Emirates.
出版信息
Clin Oral Investig. 2025 Apr 24;29(5):266. doi: 10.1007/s00784-025-06340-2.
OBJECTIVES
Longitudinal stability values of teeth after strategic implant insertion under existing removable partial dentures (RPD) are lacking. This explorative evaluation of a 3-year randomized controlled trial on strategic min-implants (MI) aims to estimate the stability changes of the remaining teeth and the tooth survival rates under different MI loading conditions.
MATERIALS AND METHODS
Partially edentulous study participants of a university clinic and three private practices with inadequately supported RPDs received strategic MIs (diameter 1.8-2.4 mm). According to the randomization the MIs were either immediately loaded in group A or delayed loaded in group B. The longitudinal changes of Periotest values (PTV) for teeth were compared between groups using mixed models adjusted by sex, age, jaw, tooth site, center, and baseline PTVs. The tooth survival was estimated with Kaplan-Meier analyses and group differences were analyzed using Cox regression.
RESULTS
Altogether 232 MIs were placed under 48 mandibular and 31 maxillary RPDs with a total of 255 remaining teeth in both jaws. The initial median PTV of 9.5 in group A and 8.0 in group B decreased to 5.0 in group A and 2.0 in group B at the 3-year follow-up. In the fully adjusted model the tooth mobility reduction revealed 5.3 PTV units (95% CI: 3.5-7.2) in group A and 7.6 PTV units (95% CI: 5.4-9.9) in group B without inferiority of any group (P = 0.122). The 3-year tooth survival rates were 88% in group A versus 92% in group B without relevant group differences (P = 0.338).
CONCLUSION
Strategic MIs under existing RPDs in persons with severe reduced dentitions decreased the mobility of the remaining teeth independent from implant loading modus. Further tooth loss can emerge despite of relieving the remaining dentition by the MIs.
STATEMENT OF CLINICAL RELEVANCE
Mini-implants as supplementary abutments can restabilize loose teeth in jaws with RPDs and unfavorable tooth distributions.
CLINICAL TRIAL REGISTRATION
German Clinical Trials Register (Deutsches Register Klinischer Studien, DRKS-ID: DRKS00007589, www.germanctr.de ), January 15th, 2015.
目的
目前尚缺乏在现有可摘局部义齿（RPD）下进行策略性种植体植入后牙齿的纵向稳定性数据。本项针对策略性微型种植体（MI）的3年随机对照试验的探索性评估旨在估计不同MI加载条件下余留牙的稳定性变化及牙齿存留率。
材料与方法
一所大学诊所及三家私人诊所中佩戴支持不足的RPD的部分牙列缺损研究参与者接受了策略性MI（直径1.8 - 2.4 mm）植入。根据随机分组，A组MI立即加载，B组MI延迟加载。使用经性别、年龄、颌骨、牙位、研究中心和基线牙周测试值（PTV）调整的混合模型比较两组牙齿PTV的纵向变化。采用Kaplan-Meier分析估计牙齿存留情况，并使用Cox回归分析组间差异。
结果
共在下颌48副和上颌31副RPD下植入232枚MI，上下颌共有255颗余留牙。A组初始PTV中位数为9.5，B组为8.0；3年随访时，A组降至5.0，B组降至2.0。在完全调整模型中，牙齿松动度降低情况显示，A组为5.3个PTV单位（95%CI：3.5 - 7.2），B组为7.6个PTV单位（95%CI：5.4 - 9.9），两组无差异（P = 0.122）。A组3年牙齿存留率为88%，B组为92%，两组无显著差异（P = 0.338）。
结论
在牙列严重缺损患者的现有RPD下植入策略性MI可降低余留牙的松动度，且与种植体加载方式无关。尽管MI减轻了余留牙列的负担，但仍可能出现进一步的牙齿缺失。
临床相关性声明
微型种植体作为辅助基牙可使佩戴RPD且牙列分布不佳的颌骨中松动牙齿重新稳定。
临床试验注册
德国临床试验注册中心（German Clinical Trials Register，DRKS-ID：DRKS00007589，www.germanctr.de），2015年1月15日。
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