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在即刻种植时使用胶原基质增强种植体周围软组织。

Use of Collagen Matrix for Augmentation of the Peri-implant Soft Tissue at the Time of Immediate Implant Placement.

作者信息

Zafiropoulos Gregor-Georg, John Gordon

机构信息

Department of Periodontology, HBM College of Dental Medicine, MBR University, Dubai, UAE. Phone: +97143838904, e-mail:

Department of Oral Surgery, Dental School, University of Duesseldorf, Duesseldorf, Germany.

出版信息

J Contemp Dent Pract. 2017 May 1;18(5):386-391. doi: 10.5005/jp-journals-10024-2052.

Abstract

AIM

The aim of this study was to determine the treatment outcome of the use of a porcine monolayer collagen matrix (mCM) to augment peri-implant soft tissue in conjunction with immediate implant placement as an alternative to patient's own connective tissue.

MATERIALS AND METHODS

A total of 27 implants were placed immediately in 27 patients (14 males and 13 females, with a mean age of 52.2 years) with simultaneous augmentation of the soft tissue by the use of a mCM. The patients were randomly divided into two groups: Group I: An envelope flap was created and mCM was left coronally uncovered, and group II: A coronally repositioned flap was created and the mCM was covered by the mucosa. Soft-tissue thickness (STTh) was measured at the time of surgery (T0) and 6 months postoperatively (T1) using a customized stent. Cone beam computed tomographies (CBCTs) were taken from 12 representative cases at T1. A stringent plaque control regimen was enforced in all the patients during the 6-month observation period.

RESULTS

Mean STTh change was similar in both groups (0.7 ± 0.2 and 0.7 ± 0.1 mm in groups I and II respectively). The comparison of STTh between T0 and T1 showed a statistically significant increase of soft tissue in both groups I and II as well as in the total examined population (p < 0.001). The STTh change as well as matrix thickness loss were comparable in both groups (p > 0.05). The evaluation of the CBCTs did not show any signs of resorption of the buccal bone plate.

CONCLUSION

Within the limitations of this study, it could be concluded that the collagen matrix used in conjunction with immediate implant placement leads to an increased thickness of peri-implant soft tissue independent of the flap creation technique and could be an alternative to connective tissue graft.

CLINICAL SIGNIFICANCE

The collagen matrix used seems to be a good alternative to patient's own connective tissue and could be used for the soft tissue augmentation around dental implants.

摘要

目的

本研究旨在确定使用猪单层胶原基质(mCM)结合即刻种植来增加种植体周围软组织的治疗效果,作为患者自身结缔组织的替代方法。

材料与方法

在27例患者(14例男性和13例女性,平均年龄52.2岁)中即刻植入27颗种植体,同时使用mCM进行软组织增量。患者被随机分为两组:第一组:制作信封瓣,mCM在冠方不覆盖;第二组:制作冠向复位瓣,mCM被黏膜覆盖。使用定制的支架在手术时(T0)和术后6个月(T1)测量软组织厚度(STTh)。在T1时从12例代表性病例中拍摄锥形束计算机断层扫描(CBCT)。在6个月的观察期内,对所有患者实施严格的菌斑控制方案。

结果

两组的平均STTh变化相似(第一组和第二组分别为0.7±0.2和0.7±0.1mm)。T0和T1之间STTh的比较显示,第一组和第二组以及所有检查人群的软组织均有统计学意义的增加(p<0.001)。两组的STTh变化以及基质厚度损失相当(p>0.05)。CBCT评估未显示颊侧骨板有任何吸收迹象。

结论

在本研究的局限性内,可以得出结论,与即刻种植结合使用的胶原基质可导致种植体周围软组织厚度增加,与瓣的制作技术无关,并且可以作为结缔组织移植的替代方法。

临床意义

所用的胶原基质似乎是患者自身结缔组织的良好替代物,可用于牙种植体周围的软组织增量。

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