定制CAD/CAM钛基台与成品钛基台用于II类拔牙窝即刻种植的对比评估：一项随机对照试验

Comparative Evaluation of Customized CAD/CAM vs. Stock Titanium Abutments for Immediate Implant Placement in Class II Extraction Sockets: A Randomized Controlled Trial.

作者信息

Robaian Ali, Hamed Mohamed Mofreh, Ahmed Yousra, Hassanein Fatma E A

机构信息

Conservative Dental Sciences Department, College of Dentistry, Prince Sattam bin Abdulaziz University, Al-Kharj 16273, Saudi Arabia.

Oral Medicine, Periodontology, and Oral Diagnosis, Faculty of Dentistry, King Salman International University, El Tur 46612, South Sinai, Egypt.

出版信息

Dent J (Basel). 2025 Aug 15;13(8):371. doi: 10.3390/dj13080371.

DOI:10.3390/dj13080371

PMID:40863074

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12385633/

Abstract

BACKGROUND

Immediate implant placement in the esthetic zone, particularly in Class II extraction sockets with partial facial bone loss, presents challenges in achieving soft and hard tissue stability. Customized computer-aided design/computer-aided manufacturing (CAD/CAM) titanium abutments may offer advantages over prefabricated stock abutments. This study compared the clinical, radiographic, and patient-reported outcomes of customized CAD/CAM titanium abutments versus stock Laser-Lok stock abutments.

MATERIALS AND METHODS

In a single-center, double-blind randomized clinical trial, 48 patients received immediate maxillary anterior implants restored with either customized CAD/CAM titanium abutments ( = 24) or stock titanium abutments ( = 24). Primary outcomes included peri-implant probing depth (PD), mucosal height, Pink Esthetic Score (PES), crestal bone level changes, and patient satisfaction assessed at baseline, 6, and 12 months post-loading. Statistical analysis included effect sizes and 95% confidence intervals.

RESULTS

At 12 months, the customized abutment group showed significantly shallower PD (mean difference: -0.54 mm; 95% CI: -0.72 to -0.35; < 0.001), higher PES (12.21 ± 0.35 vs. 10.41 ± 1.17; < 0.0001; Cohen's d = 2.08), and less crestal bone loss (1.75 ± 0.36 mm vs. 2.33 ± 0.52 mm; < 0.0001). Patient satisfaction scores were also higher in the customized group ( = 0.003). Within-group improvements were observed in both groups over time. No implant failures occurred.

CONCLUSIONS

At 1-year follow-up, customized CAD/CAM titanium abutments demonstrated improved peri-implant soft tissue parameters, esthetics, and patient satisfaction compared to stock abutments. While these findings support their use in esthetically demanding immediate implant cases, the short-term duration and single-center design warrant further long-term multicenter studies to confirm durability.

TRIAL REGISTRATION

Registered at ClinicalTrials.gov on 19/01/2025 (NCT06791655).

摘要

背景

在美学区域即刻种植，尤其是在伴有部分颊侧骨吸收的II类拔牙窝中，实现软硬组织稳定性具有挑战性。定制的计算机辅助设计/计算机辅助制造（CAD/CAM）钛基台可能比预制的成品基台具有优势。本研究比较了定制CAD/CAM钛基台与成品Laser-Lok基台在临床、影像学及患者报告结局方面的差异。

材料与方法

在一项单中心、双盲随机临床试验中，48例患者接受了上颌前牙即刻种植，并分别用定制CAD/CAM钛基台（n = 24）或成品钛基台（n = 24）进行修复。主要结局指标包括种植体周围探诊深度（PD）、黏膜高度、粉色美学评分（PES）、牙槽嵴顶骨水平变化，以及在加载后基线、6个月和12个月时评估的患者满意度。统计分析包括效应量和95%置信区间。

结果

在12个月时，定制基台组的PD显著更浅（平均差值：-0.54 mm；95% CI：-0.72至-0.35；P < 0.001），PES更高（12.21 ± 0.35 vs. 10.41 ± 1.17；P < 0.0001；Cohen's d = 2.08），牙槽嵴顶骨吸收更少（1.75 ± 0.36 mm vs. 2.33 ± 0.52 mm；P < 0.0001）。定制组的患者满意度评分也更高（P = 0.003）。两组随时间均观察到组内改善。未发生种植体失败。