摘要
目的：本临床试验旨在比较即刻种植体位于游离龈下4 mm与6 mm处，在1年后的治疗效果。
材料与方法：70枚平台转换、莫氏锥度锥形连接、颈部加工宽度1 mm的种植体，在磨牙或前磨牙区拔牙后立即以无瓣法植入。35枚种植体置于颊侧龈缘下4 mm（对照组），另外35枚置于龈缘下6 mm（试验组）。所有种植体位点均使用同种异体骨替代品进行植骨，并佩戴椅旁制作的个性化愈合基台。4个月后，使用最终螺丝固位氧化锆修复体进行修复。在最终修复体戴入时（T1）和1年后（T2）测量放射学边缘骨丧失（MBL）。在1年随访预约时（T2）记录种植体周围临床参数（探诊深度[PD]、探诊出血[BOP]和菌斑指数[PI]）。
结果：1年随访后共评估70枚种植体（对照组35枚，试验组35枚）。试验组在T1（平均值±标准差：0.11 ± 0.32 vs. 0.76 ± 0.68 mm）和T2（0.12 ± 0.23 vs. 0.54 ± 0.49 mm）时的MBL均显著低于对照组（p < 0.001）。对照组的PD均值为3.46 ± 0.74，试验组为3.49 ± 1.20，p值为0.890。两组的PI和BOP也相似：对照组PI为11%，试验组为8%（p = 0.551）；对照组BOP为13%，试验组为7%（p = 0.214）。
结论：位于颊侧中线龈下6 mm的即刻种植体比位于龈下4 mm的即刻种植体显示出显著更少的短期（长达1年）边缘骨丧失。
原文摘要
PURPOSE: This clinical trial was carried out to compare the outcomes of immediate implants positioned 4 mm below free gingival margin versus deeper placement of 6 mm after a period of 1 year.
MATERIALS AND METHODS: Seventy platform-switching implants with a Morse taper conical connection and 1 mm of machined neck were placed in a flapless approach in the molar or premolar region immediately after tooth extraction. A total of 35 implants were positioned 4 mm below the buccal gingival margin (control group), and another 35 were placed 6 mm below the gingival margin (test group). All implant sites were grafted with an allogenic bone substitute and received individual healing abutments (IHAs) made chairside. After 4 months, the implants were restored with final screw-retained zirconia restorations. Radiographic marginal bone loss (MBL) was measured at the delivery of the final restoration (T1) and after 1 year (T2). Peri-implant clinical parameters (probing depth [PD], bleeding on probing [BOP], and plaque index [PI]) were recorded at 1-year follow-up appointment (T2).
RESULTS: In total, 70 implants were evaluated after 1 year of follow-up (35 control and 35 test groups). The test group showed significantly lower (p < 0.001) MBL than the control group at both T1 (mean ± standard deviation: 0.11 ± 0.32 vs. 0.76 ± 0.68 mm) and T2 (0.12 ± 0.23 vs. 0.54 ± 0.49 mm). The PD mean was 3.46 ± 0.74 in the control group and 3.49 ± 1.20 in the test group, with a p-value of 0.890. PI and BOP were also similar in both groups: PI-11% for the control and 8% for the test groups (p = 0.551), BOP-13% for the control and 7% for the test groups (p = 0.214).
CONCLUSIONS: Immediate implants placed 6 mm below the mid-buccal gingival level showed significantly less short-term (up to 1 year) MBL than immediate implants placed 4 mm below the gingiva.
出处
Journal of prosthodontics 2026;35(7):1008-1020. DOI: 10.1111/jopr.70189.
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