Puisys Algirdas, Linkevicius Tomas
Vilnius Mokslo Group, Vilnius, Lithuania; Vilnius Implantology Center, Vilnius, Lithuania.
Clin Oral Implants Res. 2015 Feb;26(2):123-9. doi: 10.1111/clr.12301. Epub 2013 Dec 9.
To evaluate how bone-level implants maintain crestal bone stability after thickening of thin mucosal tissues with allogenic membrane.
Ninety-seven bone-level implants of 4.1 mm diameter (Institute Straumann AG, Switzerland) were evaluated in 97 patients (28 men and 69 women, mean age 47.3 ± 1.2 years). According to vertical gingival thickness, patients were assigned into test T1 (thin, 2 mm or less, n = 33), test T2 (thin thickened with allogenic membrane, n = 32) and control C groups (thick, more than 2 mm, n = 32). Implants were placed in posterior mandible in one-stage approach and after integration were restored with single screw-retained metal-ceramic restorations. Radiographic examination was performed after implant placement, 2 months after healing, after prosthetic restoration and after 1-year follow-up. Crestal bone loss was calculated mesially and distally. Mann-Whitney U-test was applied and significance was set to 0.05.
After 2 months, implants in group T1 had 0.75 ± 0.11 mm bone loss mesially and 0.73 ± 0.10 mm distally. Implants in group T2 had 0.16 ± 0.06 mm mesially and 0.20 ± 0.06 mm distally. C group implants lost 0.17 ± 0.05 mm mesially and 0.18 ± 0.03 mm distally. Differences between T1/T2, and T1/C were statistically significant (P = 0.000) both mesially and distally, while between T2 and C was not significant mesially (P = 0.861) and distally (P = 0.827). After 1-year follow-up implants in group T1 had 1.22 ± 0.08 mm bone loss mesially and 1.14 ± 0.07 mm distally. Implants in group T2 had 0.24 ± 0.06 mm mesially and 0.19 ± 0.06 mm distally. C group implants lost 0.22 ± 0.06 mm mesially and 0.20 ± 0.06 mm distally. Differences between T1/T2, and T1/C were statistically significant (P = 0.000) both mesially and distally, while between T2 and C was not significant mesially (P = 0.909) and distally (P = 0.312).
Significantly less bone loss can occur around bone-level implants placed in naturally thick mucosal tissues, in comparison with thin biotype. Augmentation of thin soft tissues with allogenic membrane during implant placement could be way to reduce crestal bone loss.
评估骨水平种植体在使用同种异体膜增厚薄黏膜组织后如何维持嵴顶骨稳定性。
对97例患者（28例男性和69例女性，平均年龄47.3±1.2岁）植入97枚直径4.1 mm的骨水平种植体（瑞士士卓曼公司）。根据垂直牙龈厚度，将患者分为试验组T1（薄，2 mm或更薄，n = 33）、试验组T2（用同种异体膜增厚的薄型，n = 32）和对照组C（厚，超过2 mm，n = 32）。种植体采用一期法植入下颌后部，愈合后用单颗螺丝固位的金属烤瓷修复体进行修复。在种植体植入后、愈合2个月后、修复后以及1年随访后进行影像学检查。计算近中和远中的嵴顶骨吸收量。应用曼-惠特尼U检验，显著性水平设定为0.05。
2个月后，T1组种植体近中骨吸收0.75±0.11 mm，远中骨吸收0.73±0.10 mm。T2组种植体近中骨吸收0.16±0.06 mm，远中骨吸收0.20±0.06 mm。C组种植体近中骨吸收0.17±0.05 mm，远中骨吸收0.18±0.03 mm。T1/T2组和T1/C组之间近中和远中的差异均具有统计学意义（P = 0.000），而T2组和C组之间近中（P = 0.861）和远中（P = 0.827）差异无统计学意义。1年随访后，T1组种植体近中骨吸收1.22±0.08 mm，远中骨吸收1.14±0.07 mm。T2组种植体近中骨吸收0.24±0.06 mm，远中骨吸收0.19±0.06 mm。C组种植体近中骨吸收0.22±0.06 mm，远中骨吸收0.20±0.06 mm。T1/T2组和T1/C组之间近中和远中的差异均具有统计学意义（P = 0.000），而T2组和C组之间近中（P = 0.909）和远中（P = 0.312）差异无统计学意义。
与薄生物型相比，植入天然厚黏膜组织中的骨水平种植体周围骨吸收明显更少。在种植体植入过程中用同种异体膜增厚薄软组织可能是减少嵴顶骨吸收的一种方法。
