Endres Janina, Strauss Franz J, Siegenthaler Marina, Naenni Nadja, Jung Ronald E, Thoma Daniel S
Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland.
Universidad Autonoma de Chile, Santiago, Chile.
J Clin Periodontol. 2025 Nov;52(11):1605-1615. doi: 10.1111/jcpe.70018. Epub 2025 Aug 20.
To evaluate the 3-year clinical and radiographic outcomes of implant-supported restorations with different emergence profiles (CONVEX vs. CONCAVE).
A total of 47 patients received a single implant in the aesthetic zone and were allocated to one of three groups: (1) CONVEX: customized provisional with a convex emergence profile (n = 15); (2) CONCAVE: customized provisional with a concave profile (n = 16); (3) Control: no provisional restoration (n = 16). Final crowns in groups CONVEX and CONCAVE were fabricated to replicate the emergence profile of the respective provisional restorations. Follow-ups were performed at baseline, 6 months, 1 year and 3 years. The primary outcome was mid-facial mucosal recession and secondary outcomes included clinical, radiographic and aesthetic outcomes as well as profilometric measurements. Multivariable logistic regressions and mixed-effects models were used to compare the groups.
Out of the 47 patients originally included, 42 were available for re-examination at 3 years follow-up. At 3 years, the frequency of mucosal recession amounted to 46.7% in group CONVEX, 13.3% in group CONCAVE and 40.0% in group Control. Adjusted logistic regression models revealed that the CONVEX group was significantly more likely to show recessions at 3 years (odds ratios [ORs]: 7.3, 95% CI: 1.02-52.14, p = 0.048) when compared with the CONCAVE group. No statistically significant difference in recession frequency was observed between the CONVEX and CONCAVE groups between the 1- and 3-year follow-ups (OR: 3.7, 95% CI: 0.30-46.09, p = 0.303).
The emergence profile design significantly influences soft tissue stability predominantly within the first year after crown insertion. Whenever clinically feasible, a CONCAVE profile is preferable in the aesthetic zone to maintain the level of the mid-facial mucosal margin and reduce the frequency of recessions.
German Clinical Trials Register: DRKS00009420.
评估具有不同龈缘形态（凸面与凹面）的种植体支持修复体的3年临床和影像学结果。
共有47例患者在美学区植入单个种植体，并被分配到三组中的一组：（1）凸面组：定制的具有凸形龈缘形态的临时修复体（n = 15）；（2）凹面组：定制的具有凹形龈缘形态的临时修复体（n = 16）；（3）对照组：无临时修复体（n = 16）。凸面组和凹面组的最终牙冠制作成与各自临时修复体的龈缘形态一致。在基线、6个月、1年和3年进行随访。主要结果是面部中部黏膜退缩，次要结果包括临床、影像学和美学结果以及轮廓测量。采用多变量逻辑回归和混合效应模型对各组进行比较。
在最初纳入的47例患者中，42例在3年随访时可进行复查。3年时，凸面组黏膜退缩的发生率为46.7%，凹面组为13.3%，对照组为40.0%。校正后的逻辑回归模型显示，与凹面组相比，凸面组在3年时出现退缩的可能性显著更高（比值比[ORs]：7.3，95%可信区间：1.02 - 52.14，p = 0.048）。在1年和3年随访之间，凸面组和凹面组在退缩频率上未观察到统计学显著差异（OR：3.7，95%可信区间：0.30 - 46.09，p = 0.303）。
龈缘形态设计主要在牙冠植入后的第一年内对软组织稳定性有显著影响。只要临床可行，在美学区采用凹形龈缘形态更可取，以维持面部中部黏膜边缘的水平并降低退缩频率。
德国临床试验注册中心：DRKS00009420。
