Merheb Joe, Vercruyssen Marjolein, Coucke Wim, Beckers Ludovic, Teughels Wim, Quirynen Marc
Unit of Periodontology, Department of Oral Health Sciences, University Hospital Leuven & University of Leuven, Leuven, Belgium.
Scientific Institute of Public Health, Brussels, Belgium.
Clin Oral Implants Res. 2017 Jan;28(1):103-108. doi: 10.1111/clr.12767. Epub 2016 Jan 8.
Buccal bone thickness is considered to be an important factor during implant surgery. Its resorption might have an effect on the soft tissue stability and eventually on implant survival. This study aimed to investigate the resorption of the buccal bone over the first 12 months after implant loading.
Twenty-four subjects (47 implants) were included. The buccal bone thickness was measured during implant surgery at several distances from the implant shoulder using a specifically designed device which allows buccal bone thickness measurements without the elevation of a muco-periostal flap. These measurements were repeated after 12 months of loading. Sixteen implants were placed flapless and 31 with the elevation of a flap. Of the latter, 19 were placed following a one-stage protocol and 12 following a two-stage protocol.
The mean reduction in buccal bone thickness, when all groups pooled, was 0.26, 0.36, 0.35 and 0.27 mm at the shoulder and 2, 4 and 6 mm apically. Implants with initial bone thickness <1mm (thin buccal plate) did not lose significantly more bone than those with an initial thickness ≥1mm (thick bone plate) except in the 'open-flap, one-stage' group (P = 0.009). A flapless procedure leads to less bone resorption compared to an open-flap procedure (P = 0.03). However, the number of surgeries (one stage vs. two stages) did not influence the rate of bone resorption (P = 0.23).
Within the limitations of this study, one might question the necessity of having a thick bone plate at the vestibular site of the implant.
颊侧骨厚度被认为是种植手术中的一个重要因素。其吸收可能会影响软组织稳定性，并最终影响种植体的存留。本研究旨在调查种植体加载后最初12个月内颊侧骨的吸收情况。
纳入24名受试者（47颗种植体）。在种植手术期间，使用专门设计的装置，在距种植体肩部不同距离处测量颊侧骨厚度，该装置无需掀起黏骨膜瓣即可测量颊侧骨厚度。在加载12个月后重复这些测量。16颗种植体采用不翻瓣植入，31颗采用翻瓣植入。在翻瓣植入的种植体中，19颗采用一期手术方案植入，12颗采用二期手术方案植入。
当所有组合并时，颊侧骨厚度在种植体肩部的平均减少量为0.26、0.36、0.35和0.27mm，在根尖2、4和6mm处的平均减少量分别为0.26、0.36、0.35和0.27mm。初始骨厚度<1mm（薄颊板）的种植体，除“翻瓣、一期”组外（P = 0.009），与初始厚度≥1mm（厚骨板）的种植体相比，骨吸收量没有显著更多。与翻瓣手术相比，不翻瓣手术导致的骨吸收更少（P = 0.03）。然而，手术次数（一期手术与二期手术）并未影响骨吸收速率（P = 0.23）。
在本研究的局限性内，人们可能会质疑在种植体前庭部位拥有厚骨板的必要性。
