用于后牙即刻种植的椅旁制作式与预成式封闭型基台：一项随机临床试验

Chairside vs Prefabricated Sealing Socket Abutments for Posterior Immediate Implants: A Randomized Clinical Trial.

作者信息

Gnusins Vitālijs, Akhondi Samuel, Zvirblis Tadas, Pala Kevser, Gallucci German O, Puisys Algirdas

机构信息

Private Practice, Adenta Clinic, Riga, Latvia.

Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA.

出版信息

Clin Implant Dent Relat Res. 2025 Aug;27(4):e70076. doi: 10.1111/cid.70076.

DOI:10.1111/cid.70076

PMID:40692347

Abstract

OBJECTIVES

This randomized clinical trial aimed to compare changes in soft tissue height, probing depth, and buccal contour volume loss following immediate implant placement using either chairside composite or prefabricated zirconia Sealing Socket Abutments (SSAs) in the posterior region.

MATERIALS AND METHODS

47 patients requiring posterior tooth extraction and immediate implant placement were randomly assigned to one of two groups: the composite Sealing Socket Abutment (CS) group (n = 24), receiving chairside-fabricated abutments, or the zirconia Sealing Socket Abutment (ZR) group (n = 23), receiving prefabricated abutments. Implants were placed immediately after extraction, using static computer-assisted implant surgery (sCAIS). Supra-Platform Tissue Height (SPTH) and total horizontal tissues (THT) were assessed using cone-beam computed tomography (CBCT) over a 3-month healing period. Implant survival, probing pocket depths (PPD), bleeding on probing (BOP) and plaque index (PI) were recorded clinically, while volumetric analysis was performed using digital impressions.

RESULTS

SPTH remained stable from baseline to the 3-month follow-up, with a mean change of -0.17 mm in the CS group and -0.44 mm in the ZR group. These differences were not statistically significant (p > 0.05). THT exhibited significant horizontal shrinkage in both groups over the 3-month period. In the CS group, THT decreased by 1.00 mm, while the ZR group showed a reduction of 1.17 mm (p < 0.001). PPD increased in the CS group from 2.8 mm to 3.7 mm on the palatal/lingual aspect and from 2.5 mm to 3.2 mm on the buccal aspect (p = 0.026). In contrast, the ZR group showed a decrease from 3.1 mm to 2.7 mm palatally/lingually and remained stable buccally at 2.6 mm to 2.7 mm (p = 0.001). BOP in the CS group decreased from 42.3% to 7.7% (p = 0.009), while the ZR group maintained low BOP levels, decreasing slightly from 17.4% to 4.4% (p = 0.346).

CONCLUSIONS

Both approaches showed comparable outcomes. ZR abutments resulted in shallower probing depths, while CS abutments showed less volumetric shrinkage. SPTH remained stable in both groups.

TRIAL REGISTRATION

This trial was registered prior to patient enrollment at ClinicalTrials.gov identifier: NCT05748379.

摘要

目的

本随机临床试验旨在比较在后部区域立即植入种植体后，使用椅旁复合材料或预制氧化锆封闭牙槽窝基台（SSA）时软组织高度、探诊深度和颊侧轮廓体积损失的变化。

材料与方法

47例需要拔除后牙并立即植入种植体的患者被随机分为两组：复合材料封闭牙槽窝基台（CS）组（n = 24），接受椅旁制作的基台；氧化锆封闭牙槽窝基台（ZR）组（n = 23），接受预制基台。拔牙后立即使用静态计算机辅助种植手术（sCAIS）植入种植体。在3个月的愈合期内，使用锥形束计算机断层扫描（CBCT）评估平台上组织高度（SPTH）和总水平组织（THT）。临床记录种植体存活率、探诊袋深度（PPD）、探诊出血（BOP）和菌斑指数（PI），同时使用数字印模进行体积分析。

结果

从基线到3个月随访，SPTH保持稳定，CS组平均变化为-0.17mm，ZR组为-0.44mm。这些差异无统计学意义（p > 0.05）。在3个月期间，两组的THT均出现明显的水平收缩。CS组THT减少1.00mm，ZR组减少1.17mm（p < 0.001）。CS组腭侧/舌侧PPD从2.8mm增加到3.7mm，颊侧从2.5mm增加到3.2mm（p = 0.026）。相比之下，ZR组腭侧/舌侧从3.1mm降至2.7mm，颊侧保持稳定，在2.6mm至2.7mm之间（p = 0.001）。CS组的BOP从42.3%降至7.7%（p = 0.009），而ZR组保持低BOP水平，从17.4%略有下降至4.4%（p = 0.346）。