Department of Dental Sciences, University of Bologna, Bologna, Italy.
Int J Oral Maxillofac Implants. 2013 Jan-Feb;28(1):270-80. doi: 10.11607/jomi.2560.
The aim of this prospective study was to evaluate the hard and soft tissue stability and esthetic outcomes of single-tooth implants placed in the anterior atrophic maxilla, following augmentation with mandibular block grafts covered with bovine hydroxyapatite and a resorbable collagen membrane, over a 5-year period.
Patients with a bony deficiency of ≥ 3 mm horizontally and ≤ 3 mm vertically were treated consecutively with reconstructive procedures and implant placement 6 months afterward. Alveolar ridge dimensions were measured before and after augmentation using computed tomography. Clinical and radiographic measurements of soft and hard tissue levels and esthetic parameters (pink esthetic score [PES]) were performed annually to assess treatment outcomes.
Twenty-nine patients were treated. One patient had partial graft exposure after 1 month that required regrafting at the time of implant placement. Mean bone gain was 4.23 ± 0.69 mm horizontally and 1.71 ± 0.75 mm vertically. The implant cumulative success rate was 100%, according to the criteria of Albrektsson et al. Mean crestal bone resorption after 5 years was low (0.61 ± 0.33 mm). Moderate recession of the facial mucosa (-1.12 ± 0.4 mm) was observed during the study period, while mesial and distal papilla heights increased slightly (0.13 ± 0.17 and 0.19 ± 0.37 mm, respectively). Mean PES ratings remained stable, varying from 9.07 ± 1.49 at the moment of definitive crown delivery to 8.61 ± 1.55 at 5 years. Only two cases (7%) were considered slightly below the defined threshold (PES = 8) of marginal esthetic acceptability.
This study demonstrated that implants placed in anterior atrophic maxillae augmented with mandibular block grafts showed stable hard and soft tissue levels and reasonable esthetic outcomes over the medium term, although ongoing recession of the facial mucosa was observed.
本前瞻性研究旨在评估在下颌骨块状移植物上覆盖牛羟磷灰石和可吸收胶原膜进行骨增量后，在前牙槽嵴萎缩的上颌中植入单颗种植体 5 年内的硬组织和软组织稳定性及美观效果。
对骨质缺损≥3mm 水平和≤3mm 垂直的患者进行连续的重建手术和种植体植入，6 个月后进行。使用计算机断层扫描术在增强前后测量牙槽嵴的尺寸。每年进行临床和放射影像学测量软组织和硬组织水平以及美观参数（粉色美学评分[PES]），以评估治疗效果。
共 29 名患者接受了治疗。1 名患者在术后 1 个月时出现部分移植物暴露，需要在植入种植体时进行再次移植。平均水平骨增量为 4.23±0.69mm，垂直骨增量为 1.71±0.75mm。根据 Albrektsson 等人的标准，种植体累计成功率为 100%。5 年后，牙槽嵴骨吸收量低（0.61±0.33mm）。研究期间观察到颊侧黏膜中度退缩（-1.12±0.4mm），而近中和远中乳头高度略有增加（0.13±0.17mm 和 0.19±0.37mm）。PES 评分均值保持稳定，从最终牙冠交付时的 9.07±1.49 变化至 5 年时的 8.61±1.55。只有 2 例（7%）被认为略低于边缘美观可接受性的定义阈值（PES=8）。
本研究表明，在前牙槽嵴萎缩的上颌中植入下颌骨块状移植物增强后的种植体在中期表现出稳定的硬组织和软组织水平和合理的美观效果，尽管观察到颊侧黏膜持续退缩。
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