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一项使用新型可吸收非交联胶原膜行去瓣单种植体位点引导骨再生的多中心随机对照临床试验:一项骨增量手术的中期结果。

A multicenter randomized controlled clinical trial using a new resorbable non-cross-linked collagen membrane for guided bone regeneration at dehisced single implant sites: interim results of a bone augmentation procedure.

机构信息

Private Clinic, Aachen, Germany.

Graduate Implant Dentistry, Loma Linda, CA, USA.

出版信息

Clin Oral Implants Res. 2017 Nov;28(11):e218-e226. doi: 10.1111/clr.12995. Epub 2016 Dec 18.

Abstract

OBJECTIVE

To compare clinical performance of a new resorbable non-cross-linked collagen membrane, creos xenoprotect (CXP), with a reference membrane (BG) for guided bone regeneration at dehisced implant sites.

MATERIALS AND METHODS

This randomized controlled clinical trial enrolled patients with expected dehiscence defects following implant placement to restore single teeth in the maxillary and mandibular esthetic zone and premolar area. Implants were placed using a two-stage surgical protocol with delayed loading. Bone augmentation material placed at the implant surface was immobilized with CXP or BG membrane. Soft tissue health was followed during the healing period, and the defect size was measured at reentry and 6 months after implant placement.

RESULTS

Of the 49 included patients, 24 were treated with CXP and 25 with BG. Patient characteristics did not differ between the two arms. In the CXP arm, the defect height at implant insertion was (mean ± SD) 5.1 ± 2.1 mm (n = 24) and reduced at reentry by 81% to 1.0 ± 1.3 mm (n = 23). In the BG arm, the defect height at implant insertion was 4.9 ± 1.9 mm (n = 25) and reduced at reentry by 62% to 1.7 ± 2.1 mm (n = 24). Assuming a margin of non-inferiority of 1 mm, CXP was non-inferior to BG. Membrane exposure rate was highest at week 3 in both arms, reaching 16.7% for BG and 8.7% for CXP.

CONCLUSIONS

The new resorbable non-cross-linked collagen membrane facilitates bone gain to support implant placement in expected dehiscence defects. The observed trend toward higher mean bone gain and lower exposure rate with CXP compared to BG should be further investigated.

摘要

目的

比较新型可吸收非交联胶原膜(creos xenoprotect,CXP)与参考膜(BG)在愈合期裂开的种植体部位行引导骨再生的临床效果。

材料和方法

本随机对照临床试验纳入了预计在种植体放置后出现骨缺损的患者,以修复上颌和下颌美学区及前磨牙区的单颗牙齿。采用二期手术方案,延迟加载种植体。在种植体表面放置骨增量材料,并用 CXP 或 BG 膜固定。在愈合期间观察软组织健康状况,并在植入后 6 个月和再次手术时测量缺损大小。

结果

49 例患者中,24 例接受 CXP 治疗,25 例接受 BG 治疗。两组患者的特征无差异。在 CXP 组,植入时的缺损高度(平均值±标准差)为 5.1±2.1mm(n=24),在再次手术时减少了 81%,为 1.0±1.3mm(n=23)。在 BG 组,植入时的缺损高度为 4.9±1.9mm(n=25),在再次手术时减少了 62%,为 1.7±2.1mm(n=24)。假设非劣效性边界为 1mm,CXP 不劣于 BG。在两个组中,膜暴露率在第 3 周最高,BG 组为 16.7%,CXP 组为 8.7%。

结论

新型可吸收非交联胶原膜有助于骨量增加,以支持预期骨缺损裂开的种植体植入。与 BG 相比,CXP 观察到的平均骨量增加更高和膜暴露率更低的趋势,应进一步研究。

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