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同期种植体植入与引导骨再生术后5年再生颊骨的锥形束计算机断层扫描评估——一项随机对照临床试验

Cone beam computed tomography evaluation of regenerated buccal bone 5 years after simultaneous implant placement and guided bone regeneration procedures--a randomized, controlled clinical trial.

作者信息

Jung Ronald E, Benic Goran I, Scherrer Daniela, Hämmerle Christoph H F

机构信息

Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland.

出版信息

Clin Oral Implants Res. 2015;26(1):28-34. doi: 10.1111/clr.12296. Epub 2013 Dec 2.

Abstract

PURPOSE

The aim of this controlled clinical study was to compare a polyethylene glycol membrane (PEG) used for bone regeneration of peri-implant defects to a collagen membrane with respect to implant survival rate, dimensions of buccal peri-implant bone and mucosa.

MATERIALS AND METHODS

Thirty-seven patients who received single tooth implants with simultaneous guided bone regeneration (GBR) in the posterior maxilla or mandible were enrolled in the study. Intra-operative heights of bone defects were assessed prior to bone augmentation. The defects were augmented with xenogenic bone mineral and randomly covered either with a porcine collagen membrane (control) or with a PEG membrane (test). Five years after implant placement, clinical evaluation and cone beam computed tomography (CBCT) scans were performed. Remaining height of bone defect, horizontal bone thickness, level of mucosal margin, and mucosal thickness were assessed in CBCT images. The difference of height of bone defect at implant placement and at 5-year follow-up was calculated. The differences between the two groups were analyzed using two-sided t-test and Mann-Whitney U-test.

RESULTS

After 5 years, 32 patients could be included and exhibited an implant survival rate of 100% for both groups. The buccal vertical bone gain between implant placement and 5-year follow-up amounted at 4.3 ± 1.5 (SD) mm and 4.8 ± 2.6 (SD) mm for the control and the test group, respectively (P = 0.493). Neither the bone height nor the thickness reached statistical significant differences between the two groups. The distance between mucosal margin and implant shoulder resulted in 0.8 ± 0.7 (SD) mm in the control and 0.5 ± 0.8 (SD) mm in the test group (P = 0.198). The mucosal thickness reached 1.4 ± 0.5 (SD) mm in the control and 1.3 ± 0.3 (SD) mm in the test group (P = 0.715). There were no significant correlations between height of bone defect at baseline and at follow-up examination and between different 5-year parameters.

CONCLUSION

A polyethylene glycol membrane used for bone regeneration of peri-implant defects performed as successfully as a collagen membrane with respect to implant survival rate and dimensions of the buccal peri-implant bone and mucosa after 5 years.

摘要

目的

本对照临床研究旨在比较用于种植体周围骨缺损骨再生的聚乙二醇膜(PEG)与胶原膜在种植体存留率、种植体颊侧骨及黏膜尺寸方面的差异。

材料与方法

本研究纳入了37例在上颌或下颌后牙区接受单颗牙种植并同期进行引导骨再生(GBR)的患者。在骨增量术前评估骨缺损的术中高度。用异种骨矿物质对缺损进行增量,并随机用猪胶原膜(对照组)或PEG膜(试验组)覆盖。种植体植入5年后,进行临床评估和锥形束计算机断层扫描(CBCT)。在CBCT图像上评估骨缺损的剩余高度、水平骨厚度、黏膜边缘水平和黏膜厚度。计算种植体植入时和5年随访时骨缺损高度的差异。采用双侧t检验和Mann-Whitney U检验分析两组之间的差异。

结果

5年后,纳入32例患者,两组种植体存留率均为100%。对照组和试验组种植体植入时与5年随访时颊侧垂直骨增量分别为4.3±1.5(标准差)mm和4.8±2.6(标准差)mm(P = 0.493)。两组之间的骨高度和厚度均未达到统计学显著差异。对照组黏膜边缘与种植体肩部之间的距离为0.8±0.7(标准差)mm,试验组为0.5±0.8(标准差)mm(P = 0.198)。对照组黏膜厚度为1.4±0.5(标准差)mm,试验组为1.3±0.3(标准差)mm(P = 0.715)。基线和随访检查时的骨缺损高度与5年时的不同参数之间均无显著相关性。

结论

在种植体存留率以及5年后种植体颊侧骨和黏膜尺寸方面,用于种植体周围骨缺损骨再生的聚乙二醇膜与胶原膜的效果相当。

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