單顆缺牙植Laser-Lok植體並立即受力,觀察三年臨床軟組織的變化及美觀影響。

Influence of a Laser-Lok surface on immediate functional loading of implants in single-tooth replacement: Three-year results of a prospective randomized clinical study on soft tissue response and esthetics. 


Guarnieri R, Grande M, Ippoliti S, Iorio-Siciliano V, Riccitiello F, Farronato D.
Int J Periodontics Restorative Dent. Volume 34, Number 5, 2015. P. 865-75.

ABSTRACT摘要
 
The purpose of the present prospective randomized study was to evaluate the influence of Laser-Lok microtextured surface on soft tissue periimplant parameters and esthetics around immediate, functionally loaded implants for single-tooth replacement in the esthetic zone. This study included 77 patients divided into two groups based on different implants used: the control group had BioHorizons tapered internal non-Laser-Lok-type implants (NLL; n = 39) and the test group had BioHorizons tapered internal Laser-Lok-type implants (LL; n = 39). Outcome measures were survival, radiographic marginal bone-level changes, soft tissue parameters, and esthetics. One implant was lost in the test group and one in the control group, for a total survival rate of 96.1% after 3 years. Radiographically, mean crestal bone loss ± standard deviation was 0.59 ±0.27 mm in the LL group compared with 1.17 ± 0.31 mm in the NLL group. A mean gain in papilla level of 0.41 ± 0.34 mm and 0.17 ± 0.36 mm was observed in the LL and the NLL groups, respectively, while the level of the midfacial peri-implant mucosa remained stable in both groups with no statistically significant differences (0.08 ± 0.42 mm for the LL group vs 0.06 ± 0.36 mm for the NLL group). The mean probing depth values in the LL and NLL groups were 0.58 ± 0.2 mm and 1.89 ± 0.3 mm, respectively. Within the limitations of this study, it was demonstrated that the clinical and esthetic outcome of immediate functional loading was more favorable for LL implants than for NLL implants.
本研究的目的是將前牙美觀區的單顆缺牙植入Laser-Lok植體,並抽樣來評估Laser-Lok表面處理微溝槽對於植體立即受力後對牙周的軟組織變化和美學的影響。本研究將77位病患分成2組,分別植入不同的植體:對照組植入沒有Laser-Lok的BioHorizons tapered internal的植體(NLL; n = 39)和測試組植入有Laser-Lok的BioHorizons tapered internal的植體(LL; n = 39)。將測量植體存活率,齒槽脊的X光片水平變化,軟組織參數,和美學結果。三年後,測試組和對照組各一支植體失敗,整體存活率為96.1%。X光片顯示,LL組平均皮質骨流失±標準偏差為0.59 ±0.27 mm,NLL組為1.17 ± 0.31 mm。LL組和NLL組的papilla-level分別平均增加為0.41 ± 0.34 mm和0.17 ± 0.36 mm,而兩組植體牙周黏膜中間水平面仍保持穩定,並無統計學的差異(LL組0.08 ± 0.42 mm vs. NLL組0.06 ± 0.36 mm)。探針測得深度平均值LL組和NLL組分別為0.58 ± 0.2 mm 和 1.89 ± 0.3 mm。本研究在有限的條件下,透過臨床和美學的結果證實,立即功能性承載下,LL植體比NLL植體更有利。
 
SOFT TISSUE FINDINGS 軟組織發現
 
Peri-implant soft tissues consisted of an epithelial barrier, with the sulcular epithelium merging with the junctional epithelium. The junctional epithelium ended abruptly at the coronal-most position of the abutment Laser-Lok microgrooves, where a zone of CT fibers appeared to enter perpendicularly into the microchanneled 0.7-mm tall band. In addition, CT fibers also appeared to enter into Laser-Lok regions of the implant collar, effectively sealing the IAJ microgap from surrounding tissues. Importantly, no evidence of an inflammatory infiltrate was found in any specimen at the IAJ.
植體周圍的軟組織由表皮細胞屏障所組成,其中牙齦溝的表皮細胞與交接的表皮細胞所融合。交接的表皮細胞延著支台齒刻有Laser-lok的微溝槽生長,其中結締組織纖維垂直進入微溝槽0.7mm高度帶。此外,結締組織纖維也進入了植體頸部具有Laser-Lok的區域,有效地將周圍組織與植體和支台齒接合處(IAJ)緊密接合。重要的是,在任何的IAJ樣本中並沒有發現發炎的細胞浸潤證據。
 
HARD TISSUE FINDINGS 硬組織發現
 
Interimplant crestal bone showed no evidence of bone resorption in any biopsy specimen at the end of 3 months. Significant bone-to-implant contact (BIC) was readily apparent along all aspects of the implant body and collar. In many specimens, regenerated bone was seen immediately proximal to the IAJ microgap. The apposition of both perpendicularly inserting CT fibers and bone onto the laser-ablated microchannels in the region of the IAJ microgap served to anatomically seal the IAJ from surrounding tissues and prevent migration of the junctional epithelium.
在3個月後的任何活檢標本中,植體間的皮質骨並沒有骨吸收的證據。可在植體本體和頸部顯著的觀察到骨頭和植體的接觸面積。在許多樣本中,可立即看到IAJ在微細縫附近的再生骨。結締組織纖維和齒槽骨兩者垂直進入IAJ有雷射刻蝕的微溝槽區域並緊密接合,以避免上部的表皮細胞往下生長。
 

 

 
 
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