Covani Ugo, Marconcini Simone, Galassini Giovanni, Cornelini Roberto, Santini Stefano, Barone Antonio
Department of Oral Medicine and Pathology, School of Dental Medicine, University of Genoa, Genoa, Italy.
J Periodontol. 2007 Aug;78(8):1644-9. doi: 10.1902/jop.2007.060461.
The purpose of the present study was to evaluate the clinical efficacy of placing implants in fresh extraction sites with simultaneous connective tissue grafting. The teeth selected for this treatment showed gingival recession and/or absence of attached gingiva.
Ten patients (five men and five women), 42 to 55 years of age, were included in the study. After initial examination and treatment planning, all of the patients selected for the study underwent periodontal treatment that was deemed necessary to favor wound healing. Subsequently, the teeth were extracted, and implants were placed without reflection of a mucoperiosteal flap. Immediately after implantation, a connective tissue graft was placed over the implants to treat the gingival recession. The second stage of surgery was performed 6 months after the initial procedure. The following clinical parameters were evaluated for each patient at 6 and 12 months after implant placement and connective tissue grafting: probing depth, probing attachment level, and mobility. Radiographs were taken using a standardized method to evaluate the marginal bone loss. Esthetic outcomes were evaluated using the measurements before implant placement and 12 months after surgery: width of the keratinized mucosa, emergence profile of the crown, and patient satisfaction.
The healing period was uneventful for all patients. All of the implants had osseointegrated. At the end of the 12-month follow-up, the patients were asymptomatic, and the implant sites showed no signs of infection or bleeding when probed. The parameters used to estimate the esthetic outcomes showed an improvement.
Implant placement immediately after tooth extraction with simultaneous connective tissue graft was considered a successful procedure. Moreover, the surgical approach used in this study can be considered a treatment option in cases with non-salvageable teeth showing gingival recession and the absence of attached gingiva.
本研究的目的是评估在新鲜拔牙位点同期进行结缔组织移植植入种植体的临床疗效。选择接受该治疗的牙齿存在牙龈退缩和/或无附着龈。
本研究纳入了10名患者（5名男性和5名女性），年龄在42至55岁之间。在进行初步检查和治疗计划后，所有入选研究的患者均接受了有利于伤口愈合的必要牙周治疗。随后，拔除牙齿，在不翻起黏骨膜瓣的情况下植入种植体。植入后立即在种植体上放置结缔组织移植片以治疗牙龈退缩。在初始手术6个月后进行第二阶段手术。在种植体植入和结缔组织移植后6个月和12个月，对每位患者评估以下临床参数：探诊深度、探诊附着水平和松动度。使用标准化方法拍摄X线片以评估边缘骨吸收。使用种植体植入前和术后12个月的测量值评估美学效果：角化黏膜宽度、牙冠龈缘轮廓和患者满意度。
所有患者的愈合过程均顺利。所有种植体均已骨结合。在12个月随访结束时，患者无症状，种植位点探诊时无感染或出血迹象。用于评估美学效果的参数有所改善。
拔牙后立即植入种植体并同期进行结缔组织移植被认为是一种成功的手术方法。此外，本研究中使用的手术方法可被视为治疗出现牙龈退缩且无附着龈的无法保留牙齿病例的一种治疗选择。
