Department of Oral Surgery, Heinrich Heine University, Düsseldorf, Germany.
Clin Oral Implants Res. 2012 Feb;23(2):191-196. doi: 10.1111/j.1600-0501.2011.02214.x. Epub 2011 Aug 2.
To investigate the impact of residual defect height (RDH) following guided bone regeneration (GBR) in dehiscence-type defects on the long-term stability of peri-implant health after a period of 4 years.
The RDH values in dehiscence-type defects at titanium implants were clinically assessed after 4 months of submerged healing following augmentation using a natural bone mineral (NBM) and a randomized application of either a cross-linked- (VN) or a native collagen membrane (BG) (n=12 patients each). The RDH values were classified as absent (0 mm, control; n=8), minimal (1 mm, test 1; n=8), or advanced (>1 mm, test 2; n=8). Clinical parameters (i.e. bleeding on probing [BOP], probing pocket depth [PD], mucosal recession [MR]) were recorded (mesio-, mid-, and disto-buccal aspects) at 4 years after prosthesis installation.
The mean PD (2.9±0.7, 2.8±0.7, 2.7±0.8 mm) values at 4 years were comparable in all the groups investigated. The mean MR values tended to be increased in both the test groups (0.5±0.7, 0.4±0.6 mm, respectively), when compared with the control group (0.2±0.3 mm) (P>0.05, respectively). The mean BOP values were also increased in both the test groups (45.8±30.5%, 54.1±24.8%, respectively), even reaching statistical significance when comparing test 2 and control (29.1±21.3%) groups (P=0.02).
The present study indicated that (i) implants exhibiting RDH values >1 mm are at a higher risk of developing peri-implant disease and (ii) positive RDH values may be associated with an increase in MR and may therefore compromise the overall esthetic outcome of implant therapy.
研究引导骨再生(GBR)后骨缺损高度(RDH)对种植体周围健康长期稳定性的影响,研究对象为 4 年时发生骨吸收的缺损。
12 名患者的钛种植体发生骨吸收缺损,使用天然骨矿物质(NBM)进行骨增量后,经过 4 个月的淹没愈合期,随机应用交联(VN)或天然胶原膜(BG)。在 4 个月时,临床评估 RDH 值。将 RDH 值分为 3 类:无(0mm,对照组;n=8)、轻度(1mm,试验 1;n=8)和重度(>1mm,试验 2;n=8)。种植体修复后 4 年,记录临床参数(探诊出血、探诊深度、黏膜退缩)(近中、中、远颊侧)。
所有研究组的平均探诊深度(2.9±0.7、2.8±0.7、2.7±0.8mm)在 4 年后均相似。与对照组(0.2±0.3mm)相比,试验组的平均黏膜退缩值均增加(0.5±0.7、0.4±0.6mm)(分别为 P>0.05)。两个试验组的探诊出血百分比(45.8±30.5%、54.1±24.8%)也增加,当比较试验 2 和对照组(29.1±21.3%)时,差异有统计学意义(P=0.02)。
本研究表明,(i)RDH 值>1mm 的种植体发生种植体周围疾病的风险较高,(ii)阳性 RDH 值可能与黏膜退缩增加有关,从而影响种植体治疗的整体美观效果。