Convex Versus Concave Emergence Profile of Implant-Supported Crowns in the Aesthetic Zone: 3-Year Results of a Randomized Controlled Trial

IF 6.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Clinical Periodontology Pub Date : 2025-08-20 DOI:10.1111/jcpe.70018

Janina Endres, Franz J. Strauss, Marina Siegenthaler, Nadja Naenni, Ronald E. Jung, Daniel S. Thoma

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引用次数: 0

Abstract

Aim

To evaluate the 3-year clinical and radiographic outcomes of implant-supported restorations with different emergence profiles (CONVEX vs. CONCAVE).

Materials and Methods

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.

Results

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).

Conclusion

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.

Trial Registration: German Clinical Trials Register: DRKS00009420

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美学区种植体支持的冠的凸出与凹出：一项为期3年的随机对照试验结果

目的：评估种植体支持的具有不同生长特征（凸与凹）的修复体的3年临床和影像学结果。材料和方法共有47例患者在美观区接受了单颗种植体，并被分为三组：(1)凸型：定制的具有凸型出现轮廓的临时种植体（n = 15）；(2)凹型：定制的凹型暂时性材料（n = 16）；(3)对照组：无临时修复（n = 16）。制作凸组和凹组的最终冠以复制各自临时修复体的出现轮廓。随访分别在基线、6个月、1年和3年进行。主要结果是中面部粘膜萎缩，次要结果包括临床、放射学和美学结果以及轮廓测量。采用多变量logistic回归和混合效应模型对两组进行比较。结果在最初纳入的47例患者中，42例在3年随访时可进行复查。3年时，凸组黏膜退缩率为46.7%，凹组为13.3%，对照组为40.0%。调整后的logistic回归模型显示，与凹组相比，凸组在3年后出现衰退的可能性更大（优势比[or]: 7.3, 95% CI: 1.02-52.14, p = 0.048）。在1年和3年随访期间，凸组和凹组的衰退频率没有统计学上的显著差异（OR: 3.7, 95% CI: 0.30-46.09, p = 0.303）。结论出牙廓设计对冠植入术后一年内软组织稳定性影响显著。在临床上可行的情况下，美学区最好采用凹形轮廓，以保持面中粘膜边缘的水平并减少衰退的频率。试验注册：德国临床试验注册：DRKS00009420

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来源期刊

Journal of Clinical Periodontology 医学-牙科与口腔外科

CiteScore

13.30

自引率

10.40%

发文量

175

审稿时长

3-8 weeks

期刊介绍： Journal of Clinical Periodontology was founded by the British, Dutch, French, German, Scandinavian, and Swiss Societies of Periodontology. The aim of the Journal of Clinical Periodontology is to provide the platform for exchange of scientific and clinical progress in the field of Periodontology and allied disciplines, and to do so at the highest possible level. The Journal also aims to facilitate the application of new scientific knowledge to the daily practice of the concerned disciplines and addresses both practicing clinicians and academics. The Journal is the official publication of the European Federation of Periodontology but wishes to retain its international scope. The Journal publishes original contributions of high scientific merit in the fields of periodontology and implant dentistry. Its scope encompasses the physiology and pathology of the periodontium, the tissue integration of dental implants, the biology and the modulation of periodontal and alveolar bone healing and regeneration, diagnosis, epidemiology, prevention and therapy of periodontal disease, the clinical aspects of tooth replacement with dental implants, and the comprehensive rehabilitation of the periodontal patient. Review articles by experts on new developments in basic and applied periodontal science and associated dental disciplines, advances in periodontal or implant techniques and procedures, and case reports which illustrate important new information are also welcome.