种植体周围粘膜表型对直接修复单牙种植体边缘骨变化的影响：一项36个月的临床试验。

IF 5.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of dentistry Pub Date : 2025-09-10 DOI:10.1016/j.jdent.2025.106100

Norberto Quispe-López , Cristina Gómez-Polo , Javier Flores-Fraile , Oscar Figueras-Álvarez , Marta Muñoz-Bruguier , Nansi López-Valverde , Javier Montero

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引用次数: 0

摘要

目的：本临床试验旨在通过分析种植体周围粘膜表型对直接螺钉保留假体修复种植体的影响，在3年随访后评估边缘骨水平的变化。方法：51例患者在上颌后段种植体56枚。根据最初的切上组织高度（STH），种植体均匀放置，切下1mm （SC）或1mm （SC）。非浸没愈合3个月后，将螺钉保留的单单元冠与假体肩关节直接连接。记录种植体植入手术（T0）和随访3、6、12、36个月（T1-T4）期间的临床数据（STH、粘膜厚度、角化粘膜宽度、KMW）和影像学数据（边缘骨重塑和边缘骨丢失，MBR和MBL分别）。MBL被认为是本研究的主要变量。结果：在12个月和36个月的随访中，平均KMW显著降低（0.3±0.7 mm）（p = .001）。36个月后，T3和T4期出现显著的MBR(0.15±0.29 mm; p = .001)，但也有一些不显著的MBL。SC定位bbb10 ~ 1mm植入体MBR水平最高，equequal植入体MBL水平最高。多元线性回归分析表明，MBR主要受种植体长度、种植体直径和种植体顶冠位置的影响，而MBL主要受种植体KMW和种植体直径的影响。结论：种植体嵴位置、种植体直径和角化粘膜宽度是种植体周围边缘骨丢失的最重要因素。临床意义：种植体周围软组织表型，特别是KMW，似乎是防止种植体周围骨质流失的主要保护因素。

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The influence of peri-implant mucosal phenotype on marginal bone changes in single-tooth implants with direct restorations: a 36-month clinical trial

Objectives

: This clinical trial aimed to evaluate changes at the marginal bone level by analysing the influence of the peri‑implant mucosal phenotype on implants restored with direct screw-retained prostheses after a 3-year follow-up.

Methods

Fifty-one patients received 56 implants in the posterior part of the maxilla or mandible. The implants were placed equicrestally, 1 mm subcrestally (SC), or > 1 mm SC, depending on the initial supracrestal tissue height (STH). After 3 months of non-submerged healing, screw-retained single-unit crowns were placed in direct connection with the implant shoulder. Clinical (STH, mucosal thickness, and keratinised mucosa width, KMW) and radiographic (marginal bone remodelling and marginal bone loss, MBR and MBL, respectively) data were recorded during the implant placement surgery (T0) and at the 3, 6, 12, and 36-month follow-ups (T1–T4). MBL was considered the main variable in this work.

Results

There was a significant reduction in the mean KMW (by 0.3 ± 0.7 mm) between the 12 and 36-month follow-up (p = .001). After 36 months, significant MBR had occurred between the T3 and T4 periods (0.15 ± 0.29 mm; p = .001), however there had also been some non-significant MBL. Implants with SC positioning > 1 mm showed the highest MBR levels, while equicrestal implants showed the highest MBL. Multiple linear regression analysis indicated that MBR is driven chiefly by implant length, implant diameter and the implant’s apico-coronal position, whereas MBL depends mainly on KMW and implant diameter.

Conclusions

Implant crestal position, implant diameter, and keratinised mucosal width were the most important factors in marginal peri‑implant bone loss.

Clinical significance

The peri‑implant soft-tissue phenotype, specifically the KMW, seems to be the main protective factor against peri‑implant bone loss.

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来源期刊

Journal of dentistry 医学-牙科与口腔外科

CiteScore

7.30

自引率

11.40%

发文量

349

审稿时长

35 days

期刊介绍： The Journal of Dentistry has an open access mirror journal The Journal of Dentistry: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The Journal of Dentistry is the leading international dental journal within the field of Restorative Dentistry. Placing an emphasis on publishing novel and high-quality research papers, the Journal aims to influence the practice of dentistry at clinician, research, industry and policy-maker level on an international basis. Topics covered include the management of dental disease, periodontology, endodontology, operative dentistry, fixed and removable prosthodontics, dental biomaterials science, long-term clinical trials including epidemiology and oral health, technology transfer of new scientific instrumentation or procedures, as well as clinically relevant oral biology and translational research. The Journal of Dentistry will publish original scientific research papers including short communications. It is also interested in publishing review articles and leaders in themed areas which will be linked to new scientific research. Conference proceedings are also welcome and expressions of interest should be communicated to the Editor.