使用数字化手术导板进行即刻种植：羟基磷灰石纳米涂层与未涂层种植体的1年结果——一项单盲随机对照试验
Immediate implant placement using a digital surgical guide with hydroxyapatite nano-coated versus uncoated implants: 1-year results of a single-blind randomized controlled trial.
文献信息
| PMID | 42849969 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Sungrak Ahn |
| 作者单位 | Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea. |
| 期刊 | Journal of periodontal & implant science |
| SCI 分区 | Q1 |
| IF | 2.9 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
目的： 本研究的主要目的是比较在上颌后牙区使用数字化手术导板植入的羟基磷灰石（HA）纳米涂层种植体与未涂层喷砂大颗粒酸蚀（SLA）种植体的1年种植成功率。次要目的是评估种植体周围临床参数、植入精度、穿出角度以及基台高度的影响。
方法： HA纳米涂层组19例患者共24枚种植体，未涂层组18例患者共26枚种植体，均使用数字化手术导板进行不翻瓣植入。结局包括种植成功、探诊深度、黏膜退缩、角化黏膜、前庭深度、改良菌斑指数、改良龈沟出血指数、边缘骨水平（MBLs）、种植体植入精度和基台高度。线性混合效应模型将导板类型和种植体表面作为固定效应，患者作为随机截距；导板类型分为牙支持式和游离端延伸式。采用回归分析评估基台高度与穿出角度之间的关联。
结果： 1年时，两组种植成功率无显著差异。临床指标和MBLs保持稳定。大多数穿出角度<30°。在未调整比较中，HA纳米涂层组若干偏离计划种植体位置的程度较小。然而，在混合效应模型中，导板类型是偏差的主要决定因素，牙支持式导板比游离端延伸式导板显示出更小的偏差。基台高度与穿出角度呈负相关，约2 mm的基台高度与约30°的穿出角度相关。
结论： 1年时，HA纳米涂层和未涂层SLA种植体在上颌后牙区即刻种植后显示出相当的临床和影像学结果。HA纳米涂层未提供可测量的益处，可能是由于当代SLA表面的天花板效应。数字化导板确保足够的基台高度和种植体深度可能有助于维持穿出角度≤30°并支持种植体周围组织健康。
试验注册： Clinical Research Information Service（CRIS）标识符：KCT0006364。
英文摘要
PURPOSE: The primary purpose of this study was to compare 1-year implant success rates between hydroxyapatite (HA) nano-coated implants and uncoated sandblasted, large-grit, acid-etched (SLA) implants placed with a digital surgical guide in the posterior maxilla. Secondary aims were to evaluate peri-implant clinical parameters, placement accuracy, emergence angle, and the influence of abutment height.
METHODS: Twenty-four implants in 19 patients in the HA nano-coated group and 26 implants in 18 patients in the uncoated group were placed flaplessly using digital surgical guides. Outcomes included implant success, probing depth, mucosal recession, keratinized mucosa, vestibular depth, modified plaque index, modified sulcular bleeding index, marginal bone levels (MBLs), implant placement accuracy, and abutment height. Linear mixed-effects models included guide type and implant surface as fixed effects and patient as a random intercept; guide type was categorized as tooth-supported or free-end extension. Regression analyses were used to assess associations between abutment height and emergence angle.
RESULTS: At 1 year, implant success did not differ significantly between groups. Clinical indices and MBLs remained stable. Most emergence angles were <30°. In unadjusted comparisons, several deviations from the planned implant position were smaller in the HA nano-coated group. However, in mixed-effects models, guide type was the principal determinant of deviation, with tooth-supported guides showing smaller deviations than free-end extension guides. Abutment height was negatively correlated with emergence angle, and an abutment height of approximately 2 mm was associated with an emergence angle of approximately 30°.
CONCLUSIONS: At 1 year, HA nano-coated and uncoated SLA implants showed comparable clinical and radiographic outcomes after immediate placement in the posterior maxilla. HA nano-coating provided no measurable benefit, possibly due to a ceiling effect of contemporary SLA surfaces. Digital guide to ensure sufficient abutment height and implant depth may help maintain emergence angles ≤30° and support peri-implant tissue health.
TRIAL REGISTRATION: Clinical Research Information Service (CRIS) Identifier: KCT0006364.