钛锆小直径种植体应用于前牙美学区的临床效果
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摘要
目的探讨钛锆小直径种植体用于前牙美学区骨量不足位点种植修复的临床效果,为其临床应用提供依据。方法对前牙美学区牙齿缺失牙槽嵴顶宽度<5.5 mm、采用钛锆直径3.3 mm种植体种植修复的30例患者的临床资料进行回顾性分析。30例患者共计植入直径3.3 mm钛锆种植体38枚。种植体植入后12个月和24个月进行临床检查和CBCT检查,评价钛锆3.3 mm小直径种植体的成功率、边缘骨吸收量,测量记录种植体周围改良菌斑指数、改良龈沟出血指数、探诊深度、粉红美学记分(pink esthetic score,PES)及修复体并发症。结果种植24个月成功率为100%。种植体植入后12个月边缘骨吸收量为(0.51±0.20)mm,24个月为(0.59±0.18)mm,边缘骨吸收不明显(t=1.381,P=0.178)。患者12个月与24个月的种植体周围改良菌斑指数、改良龈沟出血指数及探诊深度差异无统计学意义(P>0.05),牙龈健康状况良好。12个月PES为9.77±1.48,24个月为10.77±1.50(t=0.426,P=0.672),24个月与12个月相比,PES有增加趋势,但差异无统计学意义(P>0.05),总体美学效果良好,未出现修复后并发症。结论前牙美学区骨量不足位点植入钛锆小直径种植体可以获得良好的近期临床效果。
Objective To investigate the clinical effect of a titanium-zirconium small-diameter implant in anterior teeth with bone deficiencies in the esthetic area and to provide a basis for clinical application of this implant.Methods A retrospective analysis was performed using clinical data from 30 patients with a missing alveolar ridge width<5.5 mm and a titanium-zirconium 3.3 mm diameter implant prosthesis in the anterior esthetic region.A total of 38 titanium-zirconium implants with a diameter of 3.3 mm were implanted in 30 patients.Clinical examination and CBCT were performed 12 and 24 months after implantation to evaluate the success rate and marginal bone resorption of the 3.3 mm small-diameter titanium-zirconium implants.The modified plaque index,improved gingival sulcus bleeding index,exploration depth,pink esthetic score(PES)and prosthetic complications were measured and recorded.Results The 24-month success rate of the implant was 100%.The average marginal bone resorption height was 0.51±0.20 mm at 12 months after implant placement and 0.59 ± 0.18 mm at 24 months.The edge bone height did not change significantly(t=1.381,P=0.178).No significant differences were found in the modified plaque index around the implant,modified sulcus bleeding index and probing depth between 12 and 24 months(P>0.05),and the gingival health was good.The PES value was 9.77 ± 1.48 at 12 months and 10.77± 1.50 at 24 months( t=0.426,P=0.672).The PES was increased at 24 months versus 12 months,but this difference was not significant(P>0.05).The overall esthetic effect was good,and no complications occurred after repair.Conclusion Titanium-zirconium small-diameter implants can achieve good shortterm clinical results in the esthetic area of the anterior teeth.
Objective To investigate the clinical effect of a titanium-zirconium small-diameter implant in anterior teeth with bone deficiencies in the esthetic area and to provide a basis for clinical application of this implant.Methods A retrospective analysis was performed using clinical data from 30 patients with a missing alveolar ridge width<5.5 mm and a titanium-zirconium 3.3 mm diameter implant prosthesis in the anterior esthetic region.A total of 38 titanium-zirconium implants with a diameter of 3.3 mm were implanted in 30 patients.Clinical examination and CBCT were performed 12 and 24 months after implantation to evaluate the success rate and marginal bone resorption of the 3.3 mm small-diameter titanium-zirconium implants.The modified plaque index,improved gingival sulcus bleeding index,exploration depth,pink esthetic score(PES)and prosthetic complications were measured and recorded.Results The 24-month success rate of the implant was 100%.The average marginal bone resorption height was 0.51±0.20 mm at 12 months after implant placement and 0.59 ± 0.18 mm at 24 months.The edge bone height did not change significantly(t=1.381,P=0.178).No significant differences were found in the modified plaque index around the implant,modified sulcus bleeding index and probing depth between 12 and 24 months(P>0.05),and the gingival health was good.The PES value was 9.77 ± 1.48 at 12 months and 10.77± 1.50 at 24 months( t=0.426,P=0.672).The PES was increased at 24 months versus 12 months,but this difference was not significant(P>0.05).The overall esthetic effect was good,and no complications occurred after repair.Conclusion Titanium-zirconium small-diameter implants can achieve good shortterm clinical results in the esthetic area of the anterior teeth.
引文
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[10] Al-Nawas B, Domagala P, Fragola G, et al. A prospective non-interventional study to evaluate survival and success of reduced diameter implants made from titanium-zirconium alloy[J]. J Oral Implantol, 2015, 41(4):118-125.
[11]施斌,吴涛.种植修复体机械并发症的原因、预防及处理[J].口腔疾病防治, 2018, 26(7):415-421.
[12] Cordeiro JM, Beline T, Ribeiroc AL, et al. Development of binary and ternary titanium alloys for dental implants[J]. Dent Mater,2017, 33(11):1244-1257.
[13] Ting M, Tenaglia MS, Jones GH, et al. Surgical and patient factors affecting marginal bone levels around dental implants:a comprehensive overview of systematic reviews[J]. Implant Dent, 2017, 26(2):303-315.
[14] Chang M, Chronopoulos V, Mattheos N. Impact of excessive occlusal load on successfully-osseointegrated dental implants:a literature review[J]. J Investig Clin Dent, 2013, 4(3):142-150.
[15] Gomez-Florit M, Xing R, Ramis JM, et al. Human gingival fibroblasts function is stimulated on machined hydrided titanium zirconium dental implants[J]. J Dent, 2014, 42(1):30-38.
[16] Hotchkiss KM, Sowers KT, Olivares-Navarrete R. Novel in vitro comparative model of osteogenic and inflammatory cell response to dental implants[J]. Dent Mater, 2019, 35(1):176-184.
[2] Chrcanovic BR, Kisch J, Albrektsson TA. Factors influencing the fracture of dental implants[J]. Clin Implant Dent Relat Res, 2018,20(1):58-67.
[3] Brizuela-Velasco A, Perez-Pevida E, Jimenez-Garrudo A, et al.Mechanical characterisation and biomechanical and biological behaviours of Ti-Zr binary-alloy dental implants[J]. Biomed Res Int,2017, 2785863:1-10.
[4] Saulacic N, Bosshardt DD, Bornstein MM, et al. Bone apposition to a titanium-zirconium alloy implant, as compared to two other titanium-containing implants[J]. Eur Cell Mater, 2012, 23(10):273-286.
[5] 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.
[6] Mombelli A. The microbiota associated with successful or failing osseointegrated titanium implants[J]. Oral Microbiol Immunol,1987, 2(4):145-151.
[7] Fürhauser R, Florescu D, Benesch T, et al. Evaluation of soft tissue around single-tooth implant crowns:the pink esthetic score[J].Clin Oral Implants Res, 2005, 16(6):639-644.
[8] Worni A, Hicklin SP, Mericske-Stern RA. Performance and marginal bone level alteration around immediately loaded narrow-diameter implants. A prospective clinical study:results after 1 year[J]. Quintessence Int(Berl), 2018, 49(4):267-276.
[9] Schiegnitz E, Al-Nawas B. Narrow-diameter implants:a systematic review and meta-analysis[J]. Clin Oral Implants Res, 2018, 29(6):21-40.
[10] Al-Nawas B, Domagala P, Fragola G, et al. A prospective non-interventional study to evaluate survival and success of reduced diameter implants made from titanium-zirconium alloy[J]. J Oral Implantol, 2015, 41(4):118-125.
[11]施斌,吴涛.种植修复体机械并发症的原因、预防及处理[J].口腔疾病防治, 2018, 26(7):415-421.
[12] Cordeiro JM, Beline T, Ribeiroc AL, et al. Development of binary and ternary titanium alloys for dental implants[J]. Dent Mater,2017, 33(11):1244-1257.
[13] Ting M, Tenaglia MS, Jones GH, et al. Surgical and patient factors affecting marginal bone levels around dental implants:a comprehensive overview of systematic reviews[J]. Implant Dent, 2017, 26(2):303-315.
[14] Chang M, Chronopoulos V, Mattheos N. Impact of excessive occlusal load on successfully-osseointegrated dental implants:a literature review[J]. J Investig Clin Dent, 2013, 4(3):142-150.
[15] Gomez-Florit M, Xing R, Ramis JM, et al. Human gingival fibroblasts function is stimulated on machined hydrided titanium zirconium dental implants[J]. J Dent, 2014, 42(1):30-38.
[16] Hotchkiss KM, Sowers KT, Olivares-Navarrete R. Novel in vitro comparative model of osteogenic and inflammatory cell response to dental implants[J]. Dent Mater, 2019, 35(1):176-184.