Heckmann Siegfried Martin, Mörtlbauer Barbara, Rieder Dominik, Wichmann Manfred, Krafft Tim, Moralis Antonios
Int J Oral Maxillofac Implants. 2017 Mar/Apr;32(2):408-414. doi: 10.11607/jomi.4728.
When failing front teeth are replaced by implants, vestibular bone deficiencies frequently require augmentation, even though the amount of missing alveolar volume may vary. The objective of this study was to analyze the horizontal alveolar ridge dimension after implant placement and simultaneous augmentation, and to compare it to the condition at the contralateral natural site.
Forty-eight patients with a failing maxillary incisor received an immediate or early implant (Straumann Bone Level), according to a randomized study protocol. The vestibular wall of the implant site was reconstructed and moderately overcontoured with bovine hydroxyapatite and a collagen membrane (BioOss, BioGide, Geistlich). Provisional restoration followed either immediately, or after a 6-week healing period. To investigate the vestibular volume 6 months after surgery, a plaster model of the maxilla was scanned with cone beam computed tomography (CBCT; Morita 3D) and evaluated using coDiagnostiX software (Dental Wings). Statistical analysis comprised one- and two-sample t tests.
The ridge volume was not significantly influenced by the treatment schedule. The vestibular segments had a mean ± SD volume of 207.9 ± 102.5 mm³ for the implant sites, and 202.1 ± 101.5 mm³ for the corresponding natural sites (P = .28). The difference in vestibular volume between implant sites and natural tooth sites was 10.4 ± 36.2 mm³ for immediate implantation, and 0.00 ± 31.1 mm³ for early implantation (P = .32). Comparing immediate and early restoration, a difference of 0.4 mm³ and 12.5 mm³ between the implant and contralateral site was found (P = .23).
Six months after treatment, no significant differences between the alveolar volumes at augmented implant sites and natural sites were found. Moderate buccal overcontouring may have been beneficial to achieve a symmetrical contour. Long-term follow-up investigation will document if the restored volume remains stable over time.
当用种植体替代上前牙缺失时，即使缺失牙槽嵴的量有所不同，前庭骨缺损通常也需要进行增量。本研究的目的是分析种植体植入并同期增量后水平牙槽嵴的尺寸，并将其与对侧天然牙部位的情况进行比较。
根据随机研究方案，48例上颌中切牙缺失患者接受了即刻或早期种植（Straumann骨水平种植体）。种植部位的前庭壁用牛羟基磷灰石和胶原膜（BioOss、BioGide，盖氏公司）进行重建并适度超填塑形。即刻或在6周愈合期后进行临时修复。为了研究术后6个月时的前庭容积，用上颌石膏模型进行锥形束计算机断层扫描（CBCT；森田3D），并使用coDiagnostiX软件（Dental Wings）进行评估。统计分析采用单样本和两样本t检验。
治疗方案对牙槽嵴容积无显著影响。种植部位前庭段的平均容积±标准差为207.9±102.5mm³，相应天然牙部位为202.1±101.5mm³（P = 0.28）。即刻种植时种植部位与天然牙部位前庭容积的差异为10.4±36.2mm³，早期种植时为0.00±31.1mm³（P = 0.32）。比较即刻和早期修复，种植体与对侧部位之间的差异分别为0.4mm³和12.5mm³（P = 0.23）。
治疗6个月后，增量种植部位与天然牙部位的牙槽嵴容积无显著差异。适度的颊侧超填塑形可能有利于获得对称的外形。长期随访研究将记录修复后的容积是否随时间保持稳定。
