Shibly Othman, Kutkut Ahmad, Albandar Jasim M
Center for Dental Studies, State University of New York at Buffalo, Buffalo, NY 14214, USA.
J Int Acad Periodontol. 2012 Jul;14(3):62-8.
The aim of this one-year, re-entry case series was to evaluate clinically the amount of bone regeneration following the placement of immediate implants in fresh extraction sockets where bone allograft has been used to treat horizontal gaps and buccal-bone dehiscence defects in periodontally compromised patients.
Sixteen patients consented to participate, each having one immediate implant with > 3 mm buccal dehiscence bone defects and > or = 2 mm horizontal defects between the implant and socket wall. Peri-implant defects were treated using a demineralized freeze-dried bone allograft and a bioresorbable collagen membrane. Measurements of the vertical and horizontal bone defects were performed at 4 sites: buccally, mesially, distally and lingually, and were done at baseline and at 1-year follow-up.
The mean reduction in vertical defects between baseline and re-entry for all sites was 2.42 mm (p = 0.0005). Compared to lingual sites, the buccal sites showed the greatest resolution in vertical defects dimension (6.37 mm), followed by proximal sites (0.78 mm). The overall mean reduction in horizontal defects was 1.59 mm (p < 0.0001). Compared to lingual sites, the buccal sites showed the greatest resolution in horizontal gap dimension (3.2 mm), followed by proximal sites (0.8 mm). Age, defect location in the mouth and implant length did not show significant effectson the reduction in defect dimension during the first year.
A partially missing buccal plate was not a critical factor for implant success and bone regeneration of immediate implants in patients with a history of periodontal disease regardless of the time of implant loading (immediate/conventional).
本为期一年的再入路病例系列研究旨在临床评估在牙周病患者的新鲜拔牙窝中植入即刻种植体后，使用骨同种异体移植材料治疗水平骨间隙和颊侧骨开裂缺损后的骨再生量。
16名患者同意参与研究，每名患者植入一枚即刻种植体，种植体颊侧骨开裂缺损大于3mm，种植体与牙槽窝壁之间的水平缺损大于或等于2mm。种植体周围缺损采用脱矿冻干骨同种异体移植材料和可生物吸收的胶原膜进行治疗。在基线和1年随访时，在颊侧、近中、远中及舌侧4个部位对垂直和水平骨缺损进行测量。
所有部位从基线到再入路时垂直缺损的平均减少量为2.42mm（p = 0.0005）。与舌侧部位相比，颊侧部位垂直缺损尺寸的改善最为明显（6.37mm），其次是近中部位（0.78mm）。水平缺损的总体平均减少量为1.59mm（p < 0.0001）。与舌侧部位相比，颊侧部位水平间隙尺寸的改善最为明显（3.2mm），其次是近中部位（0.8mm）。年龄、口腔内缺损位置及种植体长度在第一年对缺损尺寸的减少没有显著影响。
对于有牙周病病史的患者，无论种植体加载时间（即刻/传统）如何，颊侧骨板部分缺失并非即刻种植体成功及骨再生的关键因素。
