Akcalı A, Schneider D, Ünlü F, Bıcakcı N, Köse T, Hämmerle C H F
Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey.
Clin Oral Implants Res. 2015 Jun;26(6):688-95. doi: 10.1111/clr.12368. Epub 2014 Apr 10.
To test whether or not vascularized interpositional periosteal-connective tissue grafts are as successful as free subepithelial connective tissue grafts in augmenting volume defects in the anterior maxilla.
Twenty subjects with Seibert class 1 ridge defects in the anterior maxilla were randomly, equally assigned to augmentation by vascularized interpositional periosteal-connective tissue graft (test) or free subepithelial connective tissue graft (control). Clinical periodontal parameters at teeth adjacent to the gap were recorded, and conventional impressions were taken prior to surgery (baseline = t(0)) and 1 (t(1)), 3 (t(3)) and 6 (t(6)) months after surgery. The casts were optically scanned, digitized and analyzed for ridge contour changes in the augmented area. Data were subjected to nonparametric statistics.
The contour changes in labial distance between baseline and follow-up for the control group were (median, range) 1 mm, 0.37-1.45 (t(0)-t(1)); 1.18 mm, 0.39-1.40 (t(0)-t(3)); and 0.63 mm, 0.28-1.22 (t(0)-t(6)) and for test group 1.21 mm, 0.74-2.47 (t(0)-t(1)); 1.26 mm, 0.50-1.71 (t(0)-t(3)); and 1.18 mm, 0.16-1.75 (t(0)-t(6)). Significantly less shrinkage of the graft was observed in the test group after 6 months (P = 0.03). Clinical periodontal parameters at the neighboring teeth were stable over the follow-up period and did not differ between groups.
Augmentation of single tooth gaps with moderate ridge defects in the anterior maxilla was successfully performed using both techniques. However, after 6 months, sites treated by the pediculated graft were superior in maintaining the initially augmented volume and showed less shrinkage of the graft. This could be attributed to better perfusion of the pediculated graft.
测试带血管蒂的间置骨膜 - 结缔组织移植物在增加上颌前部骨量缺损方面是否与游离上皮下结缔组织移植物同样成功。
20名上颌前部存在Seibert 1类牙槽嵴缺损的受试者被随机、等分为两组，分别采用带血管蒂的间置骨膜 - 结缔组织移植物进行增量（试验组）或游离上皮下结缔组织移植物（对照组）。记录间隙相邻牙齿的临床牙周参数，并在手术前（基线=t(0)）以及手术后1（t(1)）、3（t(3)）和6（t(6)）个月时制取传统印模。对模型进行光学扫描、数字化处理，并分析增量区域的牙槽嵴轮廓变化。数据采用非参数统计分析。
对照组基线与随访期之间唇侧距离的轮廓变化（中位数，范围）为：1mm，0.37 - 1.45（t(0)-t(1)）；1.18mm，0.39 - 1.40（t(0)-t(3)）；以及0.63mm，0.28 - 1.22（t(0)-t(6)），试验组分别为1.21mm，0.74 - 2.47（t(0)-t(1)）；1.26mm，0.50 - 1.71（t(0)-t(3)）；以及1.18mm，0.16 - 1.75（t(0)-t(6)）。6个月后试验组观察到移植物收缩明显较少（P = 0.03）。随访期间相邻牙齿的临床牙周参数保持稳定，两组之间无差异。
两种技术均成功对上颌前部单牙间隙伴有中度牙槽嵴缺损进行了增量。然而，6个月后，带蒂移植物治疗的部位在维持初始增量体积方面更优，且移植物收缩较少。这可能归因于带蒂移植物更好的血运。
