不同颈部设计种植体在骨愈合期边缘骨变化的临床分析

目的探讨口腔种植体在骨愈合过程中，种植体光滑颈部和粗糙颈部设计对边缘骨丧失的影响。 方法2008年8月至2012年3月，因第一磨牙缺失就诊于中山大学附属口腔医院种植科，接受种植义齿修复患者137例，共151颗种植体纳入研究，通过测量根尖片中种植体周围边缘骨的高度，比较光滑颈部种植体（Replace Select^TM Tapered）和粗糙颈部种植体（XiVE^TM S）在不同颌位、直径、周期中种植体周围边缘骨的各期累计丧失量和期内丧失量的差异，结果采用SPSS 19.0软件进行统计分析。 结果在愈合期，粗糙颈部种植体边缘骨丧失量[（0.17 ± 0.01）mm]比光滑颈部种植体[（0.80 ± 0.05）mm]少，差异有统计学意义（F= 94.267，P<0.001）；在二期手术至永久修复期，粗糙颈部种植体边缘骨丧失量[（0.59 ± 0.02）mm]比光滑颈部种植体[（0.34 ± 0.01）mm]多，差异有统计学意义（F= 23.651，P<0.001）。边缘骨丧失的各期累计均值，在愈合期与期内丧失量相同，在植入至永久修复期光滑组[（1.14 ± 1.19）mm]少于粗糙组[（0.75 ± 1.12）mm]，差异有统计学意义（F= 41.368，P<0.001），不同颌位或不同直径种植体边缘骨丧失的各期累计值均值及各期期内均值差异无统计学意义（P>0.05）。 结论在愈合期，与光滑颈部相比，粗糙颈部有利于减少愈合期种植体周围边缘骨丧失量；在二期手术至永久修复期，粗糙颈部和光滑颈部种植体边缘骨高度都出现明显降低，但粗糙颈部比光滑颈部种植体边缘骨丧失更多；不同直径和不同颌位种植体对边缘骨丧失无明显影响。

Comparative analysis of peri-implant marginal bone loss around two different implant neck design: a clinical study

ObjectiveTo investigate the effect of smooth-and rough-neck design of implants on the marginal bone loss during healing period. MethodsFrom August 2008 to March 2012, a total of 151 implants (Replace Select^TM Tapered or XiVE^TM S) were inserted in 137 subjects who visited the Department of Oral Implantology, Affiliated Hospital of Stomatology, Sun Yat-sen University, due to the first molar missing. The mean marginal bone loss (mMBL) of each implant was assessed with digital intraoral periapical radiograph, so that the effect of the two different neck designs above was evaluated, in which such factors as inserting site, diameter of implant and treatment phase were taken into account. The data were analyzed in statistical software (SPSS 19.0) . ResultsIn phase 1, the mMBL in the rough-neck group[ (0.17 ± 0.01) mm]was lower than that in the smooth-neck group[ (0.80 ± 0.05) mm; F= 94.267, P<0.001]. In phase 2, on the contrary, the mMBL in the rough-neck group[ (0.59 ± 0.02) mm]was found to be higher than that in the smooth neck-group[ (0.34 ± 0.01) mm; F= 23.651, P<0.001]. From phase 1 to 2, the accumulated mMBL in the smooth neck group[ (1.14 ± 1.19) mm]was lower than that in the rough-neck group[ (0.75 ± 1.12) mm; F= 41.368, P<0.001]. There was no significant difference in mMBL between implants with different diameters or inserting sites (P>0.05) . ConclusionsIn phase 1, implants with a rough-neck design may help maintain the marginal bone level. Nevertheless, the bone level of implants with either a rough-or a smooth-neck design was found to decrease after the placement of abutment. The bone loss around the implants with a rough-neck design was higher than that with a smooth-neck design in phase 2. The change of marginal bone level was not related to the implant diameter, or the inserting site in this study.