平台转换连接与对接连接在即刻功能性负重中的对比研究

The comparative study in immediate-loading implant using platform switching and butt-joint

目的:评价平台转换连接与对接连接种植体即刻功能性负重后短期内的边缘骨丧失及牙龈变化情况。方法:选择上下颌前牙为观察对象,拔除后行即刻种植且功能性负重患者50例,根据种植体-基台连接设计不同随机分为两组,平台转换组25例选用Nobel Active种植体;对接连接组25例,选用Nobel Replace种植体。两组患者种植术后即刻戴入临时冠行使功能性负重,12个月后更换为永久修复体。所有病例进行影像学检测(包括CT、X线全景片、X线根尖片)评估两种连接方式的种植体边缘骨的吸收情况及牙龈位置变化情况。结果:两组种植体均完成骨结合及软组织愈合,随访期内,种植体无松动、脱落,牙龈组织健康,成功率均为100.0%。功能性负载12个月时测得种植体边缘骨吸收,平台转换组为1.09±0.62 mm,对接连接组为1.43±0.62 mm,差异无统计学意义(P>0.05)。临时冠戴入12个月时平台转换组探诊深度(PD)2.71±0.65 mm,对接连接组探诊深度(PD)2.98±0.86 mm,差异有统计学意义(P<0.05)。结论:将平台转换技术应用于即刻种植且功能性负重时,短期内种植体颈部边缘骨的吸收与对接连接组比较虽然无明显差异,但牙龈探诊深度优于对接连接组,对临床应用具有参考价值。

Objective： To evaluate and compare the losing of marginal bone and the changes of gingival after immediate implant and functional loading of dental implant with platform-switching implants and butt-joint implants at the short term. Methods： Fifty patients,whose upper and lower front teeth could not be reserved,receiving immediate implant and functional load after teeth pulled out,were divided into two groups equally. One group use the platform-switching implants（ Nobel Active） and the other group use butt-joint implants（ Nobel Replace）. After 12 months,the two groups＇ restorations were replaced by permanent restorations. Imaging tests were carried out in all cases（ including CT,panoramic films,periapical films）. Evaluate and compare the marginal bone loss of two kinds of implants by imaging detection and observe the position changes of gingival. Results： The implant success rate of two groups were 100%. No implant was loose or fall off and the gingivals were healthy. The average value of marginal bone loss of platform-switching implants was 1. 09 ± 0. 62 mm,while the other group was 1. 43 ± 0. 62 mm and there was no significant difference（ P 0. 05）. The average PD of platform-switching implants was 2. 71 ± 0. 65 mm,while the other group was 2. 98 ± 0. 86 mm and the difference was statistically significant（ P 0. 05）. Conclusion： The losing of marginal bone after immediate implant and functional loading has no significant difference at the short term between platform-switching and butt-joint. But the gingival probing depth is better than the butt-joint,which has reference value to clinical application.