不同初始生物学宽度对单纯锥度固位种植体边缘骨吸收的影响

doi:10.12337/zgkqzzxzz.2025.10.003

摘要/Abstract

摘要： 目的以单纯锥度固位种植体为研究对象,分析不同初始生物学宽度（IBW）对其边缘骨吸收（MBL）是否具有差异性。方法选取2018年1月至2020年12月于南昌大学第四附属医院行种植修复的患者83例,种植体122颗（种植位点近远中向IBW 244个）,按照不同IBW分为A（1.24~3.56 mm）、B（3.59~4.33 mm）、C（4.36~5.21 mm）、D（5.23~8.53 mm）4个组,于术后即刻（T1）、修复后即刻（T2）、随访3~5年（T3）拍摄影像学资料,观察MBL情况,分析单纯锥度固位种植系统不同IBW是否会影响种植体MBL。结果 T1-T2时期,A组MBL显著低于C组和D组（P<0.05）,B组MBL显著低于D组（P<0.05）。T1-T3时期,A组MBL显著低于D组（P<0.05）。T2-T3时期,MBL差异在4个组之间无统计学意义（P>0.05）。在黏膜厚度亚组的比较中,A、B 2组薄龈与厚龈种植位点在MBL差异无明显统计学意义（P>0.05）,在C组T1-T2及T1-T3时期薄龈相比厚龈种植位点显现出更多的骨吸收（P<0.05）,D组中在T1-T2时期薄龈相比厚龈种植位点显现出更多的骨吸收（P<0.05）。结论在种植体植入后到冠修复完成阶段, IBW较大（≥4.36 mm）的种植位点可观察到更多的MBL,单纯锥度固位种植系统的IBW在负荷后对MBL无显著影响;骨改建阶段,厚龈生物型相较薄龈生物型可在一定程度上抑制MBL。故本研究建议将单纯锥度固位种植体植入骨下≥2 mm以避免种植体螺纹早期暴露。

关键词: 单纯锥度固位种植体, 生物学宽度, 黏膜厚度, 种植深度, 边缘骨吸收

Abstract: Objective To investigate whether there is a difference in the marginal bone loss (MBL) of purely conical retained implants with different initial biological widths (IBW). Methods Eighty-three patients with 122 implants (244 initial biological width sites mesial and distal aspects) who underwent implant restorations in the Fourth Affiliated Hospital of Nanchang University from January 2018 to December 2020 were selected for retrospective analysis. The initial biological widths were divided into four groups, A(1.24~3.56 mm), B(3.59~4.33 mm), C(4.36~5.21 mm), and D(5.23~8.53 mm), according to the different sizes, and the MBL was observed by taking imaging data at the the immediately post-surgery (T1), immediately post-prosthesis delivery (T2), and 3~5 year follow-up (T3), to explore whether the different initial biological widths of the purely taper-retained implant system would affect the peri-implant MBL. Results In the T1-T2 period, MBL was significantly lower in group A than in groups C and D (P<0.05), and in group B than in group D (P<0.05).In the T1-T3 period, MBL was significantly lower in group A than in group D (P<0.05).In the T2-T3 period, MBL was not statistically different among the four groups (P>0.05). In the comparison of mucosal thickness subgroups, there was no significant difference in MBL between thin and thick gingival sites in groups A and B (P>0.05), in group C, thin gingival sites showed more bone loss in the T1-T2 and T1-T3 periods compared to thick gingival group (P<0.05), and thin gingival group sites showed more bone loss in the T1-T2 period compared to thick gingival group in group D (P<0.05). Conclusion More marginal bone loss was observed at sites with larger IBW (≥4.36 mm) after implant placement to the stage of completion of prosthetic restoration, and the IBW of the simple taper-retained implant system has no significant effect on the MBL after functional loading; in the bone remodeling stage, the thicker gingival biotypes can inhibit the MBL to a certain extent compared with the thinner gingival biotypes; we recommend implanting purely conical retained implants to a subosseous depth of ≥2 mm in order to avoid early exposure of implant threads.

Key words: Taper-retained implant, Biological width, Mucosal thickness, Subcrestal placement depth, Marginal bone loss

徐业豪,任碧晖,戴婕婷,等. 不同初始生物学宽度对单纯锥度固位种植体边缘骨吸收的影响[J]. 中国口腔种植学杂志, 2025, 30(5): 440-448. DOI: 10.12337/zgkqzzxzz.2025.10.003

Xu Yehao, Ren Bihui, Dai Jieting, Guo Shuigen, Wei Hongwu. Effect of different initial biologic width on marginal bone loss in purely conical retained implants[J].Chinese Journal of Oral Implantology, 2025, 30(5): 440-448.DOI: 10.12337/zgkqzzxzz.2025.10.003.

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