Marco Tallarico^1,*; Nicola Baldini^2,*; Fulvio Gatti³; Łukasz Zadrożny⁴; Erta Xhanari⁵; Roberto Scrascia⁶

¹School of Dentistry, University of Sassari, Sassari; ²University of Siena, Siena; ³University of Milan, Milano, Italy; ⁴University of Warsaw, Warsaw, Poland; ⁵Aldent University, Tirana, Albania; ⁶University of Foggia, Foggia, Italy

Background: Implant stability is one of the most important factors that may affect osseointegration during the healing period. In fact, early failure occurs prior the definitive prosthesis delivery, as consequence of a lack of integration. In the last years, dental industry introduced in the market implants with modified surfaces with the aim to enhance the osseointegration, reducing the risks of implant failure and complications during the osseointegration period.

Aim/Hypothesis: To compare early implant failure and implant stability of one-stage Hiossen ET III implants with its new hydrophilic (NH) surface, compared with Hiossen ET III implants with the well-known SA surface at the two years follow-up.

Material and Methods: This study was designed as multicenter, randomized controlled split-mouth trial was aimed to compare SA surface implants (SA group) and implants with a newly developed bioabsorbable apatite nanocoating surface (NH group). Patients required two implants to rehabilitate with single crowns were considered eligible for this research. Outcomes were: implant and prosthetic survival rates, any biological or mechanical complications, insertion torque at implant placement, and the implant stability quotient (ISQ). Data were collected and analyzed up to 2-yeart after loading.

Results: Overall 29 patients were treated according to the allocated interventions, and followed up to two-year after loading. No patient dropped out. A total of 58 implants (29 of SA surface and 29 of SA surface with the newly developed bioabsorbable apatite nanocoating) were placed. Two years after loading, no implant and no prosthesis failed. The mean insertion torque ranged between 35.0 and 45.0 Ncm (mean of 40.5 ± 3.23 (38.17 – 41.83) Ncm in the SA group and 40.48 ± 3.49 (38.02 – 41.98) Ncm in the NH group). The difference between groups was not statistically significant (p = 0.981). The comparison between ISQ values showed a statistically significant difference between groups at the second week after implant placement (T2) with higher values in the NH group (p = 0.041). Similar results were found in the maxilla (p = 0.045), but not in the mandible (p = 0.362). A positive correlation was found between initial insertion torque and ISQ with higher value in the NH group (0.73 versus 0.66).

Conclusion and Clinical implications: NH implants showed encouraging results in term of implant stability, success and survival rates and are a viable alternative to SA surface, as they seem to avoid the ISQ drop during the remodeling phase. Implants with NH surface could be finally suggested for immediate loading, immediate implants, immunocompromised patients, and one-stage guided bone regenerations. Further researches are needed to evaluate the potential benefit of NH surface implants in problematic clinical situations.

Disclosure of Interest: None Declared

Keywords: dental implants, osseointegration, surface modification

马可·塔拉里科^1,* ; 尼古拉·巴尔蒂尼^2,* ; 富尔维奥·加蒂³ ; Łukasz Zadrożny ⁴ ; Erta Xhanari ⁵ ; 罗伯托·斯克拉夏⁶

¹萨萨里大学牙科学院，萨萨里；²锡耶纳大学，锡耶纳；³米兰大学，米兰，意大利；⁴华沙大学，华沙，波兰；⁵奥尔登特大学，阿尔巴尼亚地拉那；⁶福贾大学，意大利福贾

背景：种植体稳定性是可能影响愈合期间骨整合的最重要因素之一。事实上，由于缺乏整合，早期失败发生在最终的假体交付之前。近年来，牙科行业在市场上推出了表面改性的种植体，旨在增强骨整合，降低骨整合期间种植体失败和并发症的风险。

目的/假设：在两年的随访中，比较具有新型亲水 (NH) 表面的一期 Hiossen ET III 种植体与具有众所周知的 SA 表面的 Hiossen ET III 种植体的早期种植体失败和种植体稳定性。

材料和方法：本研究设计为多中心、随机对照的分口试验，旨在比较 SA 表面植入物（SA 组）和具有新开发的生物可吸收磷灰石纳米涂层表面（NH 组）的植入物。需要两个种植体进行单牙冠修复的患者被认为符合这项研究的条件。结果是：种植体和修复体存活率、任何生物或机械并发症、种植体植入时的插入扭矩以及种植体稳定性商数 (ISQ)。在加载后收集和分析长达 2 年的数据。

结果：总共 29 名患者根据分配的干预措施接受治疗，并在负荷后随访至两年。没有病人中途退出。总共放置了 58 个植入物（29 个 SA 表面和 29 个带有新开发的生物可吸收磷灰石纳米涂层的 SA 表面）。加载两年后，没有植入物和假体失败。平均插入扭矩介于 35.0 和 45.0 Ncm 之间（SA 组的平均值为 40.5 ± 3.23 (38.17 – 41.83) Ncm，NH 组的平均值为 40.48 ± 3.49 (38.02 – 41.98) Ncm）。组间差异无统计学意义（p = 0.981）。ISQ值之间的比较显示，种植体植入后第二周（T2）组间差异有统计学意义，NH组的值较高（p= 0.041）。在上颌骨 ( p = 0.045)中发现了类似的结果，但在下颌骨 ( p = 0.362) 中没有发现类似的结果。发现初始插入扭矩和 ISQ 之间呈正相关，NH 组的值较高（0.73 对 0.66）。

结论和临床意义： NH 种植体在种植体稳定性、成功率和存活率方面显示出令人鼓舞的结果，并且是 SA 表面的可行替代品，因为它们似乎避免了重塑阶段的 ISQ 下降。具有 NH 表面的植入物最终可用于即刻负重、即刻种植、免疫功能低下的患者和一期引导骨再生。需要进一步的研究来评估 NH 表面植入物在有问题的临床情况下的潜在益处。

利益披露：无申报

关键词: 牙种植体, 骨整合, 表面改性