4种不同穿龈高度的修复基台对边缘骨吸收影响的5年临床观察

doi:10.12337/zgkqzzxzz.2022.02.005

摘要/Abstract

摘要： 目的评价不同穿龈高度的修复基台在种植修复5年后的长期临床疗效。方法选取2015年1月至2015年9月于南昌大学第四附属医院口腔科就诊的牙列缺损行种植修复的患者,根据完成最终修复时选用修复基台的不同穿龈高度将其分为4组：A组（≤1 mm）、B组（2 mm）、C组（3 mm）、D组（4 mm）,根据分组情况分别测量每颗种植体在种植即刻、完成最终修复时以及修复负荷至少5年之后的曲面体层放射线片,分析种植体颈部的骨组织变化情况。结果在观察期内,经过至少5年的功能性负荷,63颗种植体的留存率为96.83%;4组种植体的周围骨组织吸收量中A组[T2-T1:（-0.627 ±1.030） mm]与B组[T2-T1:（-0.017±0.424 ）mm]的差异具有统计学意义（P<0.05）;不同穿龈高度的修复基台与种植体颈部平台暴露关系差异具有统计学意义（P<0.05）。结论自锁锥度固位种植体在完成最终修复时选用不同的穿龈高度的修复基台对种植体周围骨组织的吸收量有一定的影响,在植入深度相同的情况下用长穿龈修复基台可以减少在功能负荷后种植体颈部平台的暴露,从而降低种植体受周围环境感染的风险。

关键词: 锥度种植体, 穿龈高度, 骨吸收, 平台暴露

Abstract: Objective To evaluate the long-term clinical efficacy of restoration abutments with different transgingival heights after 5 years of implant restoration. Methods Patients who underwent implant restoration for dental defects in the Department of Stomatology, the Fourth Affiliated Hospital of Nanchang University from January 2015 to September 2015 were selected and divided into four groups according to the different transgingival heights of the restoration abutment selected when the final restoration was completed: Group A (≤1 mm), Group B (2 mm), Group C (3 mm), Group D (4 mm). According to the grouping situation, measurement was performed immediately after the implantation, when the final restoration was completed, and at least 5 years after the restoration using curved tomography to analyze the changes in the bone tissue at the implant neck. Results During the observation period, after at least 5 years of functional loading, the success rate of 63 implants was 96.83%. Among the four groups, the amount of bone tissue absorption around the implant in group A [T2-T1:（-0.627 ±1.030） mm]and in group B[T2-T1:（-0.017±0.424 ）mm]was statistically significant (P<0.05). The relationship between the prosthetic abutment with different transgingival heights and the exposure of the implant neck platform was statistically significant (P<0.05). Conclusion For self-locking taper-retained implants, when the final restoration is completed, the choice of restoration abutments with different gingival heights will have a certain impact on the absorption of bone tissue around the implant. Long gingival restorations are used under the same implant depth. The table can reduce the exposure of the implant neck platform after functional weight-bearing, thereby reducing the risk of infection of the implant from the surrounding environment.

Key words: Taper implant, Transmucosal height, Bone resorption, Platform exposure

杨晶晶,胡常琦,余正荣,等. 4种不同穿龈高度的修复基台对边缘骨吸收影响的5年临床观察[J]. 中国口腔种植学杂志, 2022, 27(1): 22-27. DOI: 10.12337/zgkqzzxzz.2022.02.005

Yang Jingjing, Hu Changqi, Yu Zhengrong, Gong Jinmei, Huang Jiangqin, Wei Hongwu. A 5-year clinical observation on the effect of four different transmucosal height restoration abutments on marginal bone resorption[J].Chinese Journal of Oral Implantology, 2022, 27(1): 22-27.DOI: 10.12337/zgkqzzxzz.2022.02.005.

参考文献

[1] 安辉. 口腔种植修复和常规修复在牙列缺损治疗中的效果对比[J].中国实用医药,2021,16(20):100-102. DOI: 10.14163/j.cnki.11-5547/r.2021.20.036.
[2] Romanos GE, Aydin E, Gaertner K, et al.Long-term results after subcrestal or crestal placement of delayed loaded implants[J]. Clin Implant Dent Relat Res, 2015,17(1):133-141. DOI: 10.1111/cid.12084.
[3] Cassetta M, Driver A, Brandetti G, et al.Peri-implant bone loss around platform-switched morse taper connection implants: a prospective 60-month follow-up study[J]. Int J Oral Maxillofac Surg, 2016,45(12):1577-1585. DOI: 10.1016/j.ijom.2016.09.009.
[4] Albrektsson T, Zarb G, Worthington P, et al.The long-term efficacy of currently used dental implants: a review and proposed criteria of success[J]. Int J Oral Maxillofac Implants, 1986,1(1):11-25.
[5] 黄江琴, 王轶, 岑雯, 等. 种植体植入深度对边缘骨水平影响的临床研究[J].中国口腔种植学杂志,2019,34(1):14-18. DOI: 10.3969/j.issn.1007-3957.2019.01.004.
[6] Mannu GS, Sudul M, Bettencourt-Silva JH, et al.Role of tamoxifen in idiopathic gynecomastia: a 10-year prospective cohort study[J]. Breast J, 2018,24(6):1043-1045. DOI: 10.1111/tbj.13080.
[7] Engquist B, Astrand P, Anzén B, et al.Simplified methods of implant treatment in the edentulous lower jaw: a 3-year follow-up report of a controlled prospective study of one-stage versus two-stage surgery and early loading[J]. Clin Implant Dent Relat Res, 2005,7(2):95-104. DOI: 10.1111/j.1708-8208.2005.tb00052.x.
[8] Mameno T, Wada M, Otsuki M, et al.Risk indicators for marginal bone resorption around implants in function for at least 4 years: a retrospective longitudinal study[J]. J Periodontol, 2020,91(1):37-45. DOI: 10.1002/JPER.18-0756.
[9] Yi JM, Lee JK, Um HS, et al.Marginal bony changes in relation to different vertical positions of dental implants[J]. J Periodontal Implant Sci, 2010,40(5):244-248. DOI: 10.5051/jpis.2010.40.5.244.
[10] Hermann JS, Cochran DL, Nummikoski PV, et al.Crestal bone changes around titanium implants. a radiographic evaluation of unloaded nonsubmerged and submerged implants in the canine mandible[J]. J Periodontol, 1997,68(11):1117-1130. DOI: 10.1902/jop.1997.68.11.1117.
[11] Broggini N, McManus LM, Hermann JS, et al. Peri-implant inflammation defined by the implant-abutment interface[J]. J Dent Res, 2006,85(5):473-478. DOI: 10.1177/154405910608500515.
[12] 苟敏, 蔡潇潇. 种植体-基台微间隙对种植体颈部周围骨的影响[J].国际口腔医学杂志,2015,(6):733-738. DOI: 10.7518/gjkq.2015.06.027.
[13] 孟展, 魏洪武, 郭水根, 等. 4例bicon种植失败原因分析[J].中国口腔种植学杂志,2016,21(2):88-90.
[14] Luongo R, Traini T, Guidone PC, et al.Hard and soft tissue responses to the platform-switching technique[J]. Int J Periodontics Restorative Dent, 2008,28(6):551-557.
[15] 夏勋, 胡常琦, 黄江琴, 等. 短种植体冠根比对骨改建的影响:5年临床观察[J].口腔医学研究,2020,36(7):683-687. DOI: 10.13701/j.cnki.kqyxyj.2020.07.017.
[16] Da Silva K, Joly JC, Peruzzo DC, et al.Influence of transmucosal height on loss of prosthetic abutment torque after mechanical cycling[J]. J Oral Implantol, 2018,44(6):423-426. DOI: 10.1563/aaid-joi-D-17-00250.
[17] Chapman RJ, Grippo W.The locking taper attachment for implant abutments: use and reliability[J]. Implant Dent, 1996,5(4):257-261. DOI: 10.1097/00008505-199600540-00004.
[18] Mangano C, Bartolucci EG.Single tooth replacement by morse taper connection implants: a retrospective study of 80 implants[J]. Int J Oral Maxillofac Implants, 2001,16(5):675-680.
[19] Sannino G, Barlattani A.Mechanical evaluation of an implant-abutment self-locking taper connection: finite element analysis and experimental tests[J]. Int J Oral Maxillofac Implants, 2013,28(1):e17-26. DOI: 10.11607/jomi.2058.
[20] Mangano C, Iaculli F, Piattelli A, et al.Fixed restorations supported by morse-taper connection implants: a retrospective clinical study with 10-20 years of follow-up[J]. Clin Oral Implants Res, 2015,26(10):1229-1236. DOI: 10.1111/clr.12439.
[21] 孙斌, 李德华, 马威, 等. 牙种植患者主观满意度的调查[J].临床口腔医学杂志, 2008,24(6):357-359. DOI: 10.3969/j.issn.1003-1634.2008.06.014.
[22] Wang X, Kattan MW.Cohort studies: design, analysis, and reporting[J]. Chest, 2020,158(1S):S72-S78. DOI: 10.1016/j.chest.2020.03.014.