State Key Laboratory of Oral Diseases and Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
State Key Laboratory of Oral Diseases and Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
J Dent. 2017 Oct;65:95-100. doi: 10.1016/j.jdent.2017.07.010. Epub 2017 Jul 21.
To evaluate bone reconstruction and soft tissue reactions at immediate implants placed into intact sockets and those with buccal bone dehiscence defects.
Fifty-nine internal connection implants from four different manufacturers were immediately placed in intact sockets(non-dehiscence group, n=40), and in alveoli with buccal bone dehiscence defects: 1) Group 1(n= N10), the defect depth measured 3-5 mm from the gingival margin. 2) Group 2(n=9), the depth ranged from 5mm to 7mm. The surrounding bony voids were grafted with deproteinized bovine bone mineral (DBBM) particles. Cone beam computed tomography(CBCT) was performed immediately after surgery (T1), and at 6 months later(T2). Radiographs were taken at prosthesis placement and one year postloading(T3). Soft tissue parameters were measured at baseline (T0), prosthesis placement and T3.
No implants were lost during the observation period. For the dehiscence groups, the buccal bone plates were radiographically reconstructed to comparable horizontal and vertical bone volumes compared with the non-dehiscence group. Marginal bone loss occurred between the time of final restoration and 1-year postloading was not statistically different(P=0.732) between groups. Soft tissue parameters did not reveal inferior results for the dehiscence groups.
Within the limitations of this study, flapless implant placement into compromised sockets in combination with DBBM grafting may be a viable technique to reconstitute the defected buccal bone plates due to space maintenance and primary socket closure provided by healing abutments and bone grafts.
Immediate implants and DBBM grafting without using membranes may be indicated for sockets with buccal bone defects.
评估即刻植入物在完整牙槽窝和颊侧骨缺损中的骨重建和软组织反应。
将来自四个不同制造商的 59 个内部连接种植体即刻植入完整牙槽窝（非缺损组，n=40）和颊侧骨缺损牙槽窝：1）组 1（n=10），从龈缘测量缺损深度为 3-5mm。2）组 2（n=9），深度范围为 5mm 至 7mm。周围的骨空隙用脱蛋白牛骨矿物质（DBBM）颗粒填充。术后即刻（T1）和 6 个月后（T2）进行锥形束 CT（CBCT）检查。在修复体放置和加载后 1 年（T3）拍摄 X 光片。在基线（T0）、修复体放置和 T3 时测量软组织参数。
在观察期间，没有种植体丢失。对于缺损组，颊侧骨板在影像学上重建为与非缺损组可比的水平和垂直骨量。最终修复体和加载后 1 年之间的边缘骨丧失在组间无统计学差异（P=0.732）。缺损组的软组织参数未显示出较差的结果。
在本研究的限制范围内，无瓣即刻种植体植入结合 DBBM 移植可能是一种可行的技术，通过愈合基台和骨移植提供的空间维持和初始牙槽窝闭合，可重建由于空间丧失导致的颊侧骨板缺损。
对于颊侧骨缺损的牙槽窝，无需使用膜的即刻种植体和 DBBM 移植可能是可行的选择。
