Department of Periodontics, Chi Mei Medical Center, Liouying, Tainan, Taiwan.
Department of Periodontics, Chi Mei Medical Center, Yongkang, Tainan, Taiwan.
J Periodontol. 2019 Mar;90(3):247-255. doi: 10.1002/JPER.17-0491. Epub 2018 Nov 15.
Early implant placement combined with simultaneous contour augmentation was able to rebuild stable facial hard-tissue and soft-tissue contours that were esthetically pleasing. The purpose of this study was to evaluate the clinical esthetic outcome, when two different bone grafting materials were used.
Forty-eight patients were randomly assigned into two groups. In the control group, autogenous bone was used to cover the exposed implant surface then a layer of deproteinized bovine bone mineral (DBBM) was added. This graft combination was then combined with a collagen membrane. In the test group, the exposed implant surface was covered with a layer of freeze-dried bone allograft (FDBA) in combination with the collagen membrane. Modified plaque index (mPI), modified sulcular bleeding index (mSBI), probing depth (PD), keratinized mucosa (KM), implant crown length (IC), distance from the implant shoulder radiographic bone-to-implant contact (DIB), pink esthetic score (PES), and white esthetic score (WES) were measured at 12-months post implant loading.
All 48 implants were clinically successful, and no significant differences were observed in mPI, mSBI, PD, KM, IC, DIB, PES, and WES at 1-year implant loading. The mean mucosal recessions of test and control group were unchanged, 0 and -0.02 mm, respectively. The mean DIB were -0.32 and -0.21 mm in test and control implants, respectively. The mean totals of PES/WES were 15.29 and 15.33 for the test and control groups, respectively, with no significant difference between groups.
This study demonstrated that autogenous bone plus DBBM and FDBA each combined with a collagen membrane both resulted in stable clinical and esthetic outcomes in early implant placement with contour augmentation after 1 year.
早期植入物放置结合同时的轮廓增强能够重建美观的稳定面部硬组织和软组织轮廓。本研究的目的是评估两种不同骨移植材料的临床美学效果。
将 48 名患者随机分为两组。在对照组中,使用自体骨覆盖暴露的种植体表面,然后添加一层脱蛋白牛骨矿物质(DBBM)。这种移植物组合然后与胶原膜结合。在实验组中,将冻干骨同种异体移植物(FDBA)的一层覆盖在暴露的种植体表面,与胶原膜结合。在种植体负荷后 12 个月,测量改良菌斑指数(mPI)、改良龈沟出血指数(mSBI)、探诊深度(PD)、角化黏膜(KM)、种植体冠长(IC)、种植体肩距放射状骨-种植体接触(DIB)、粉红色美学评分(PES)和白色美学评分(WES)。
所有 48 个种植体均临床成功,在种植体负荷后 1 年,mPI、mSBI、PD、KM、IC、DIB、PES 和 WES 无显著差异。实验组和对照组的平均黏膜退缩分别为 0 和 -0.02mm,实验组和对照组的平均 DIB 分别为 -0.32 和 -0.21mm。实验组和对照组的 PES/WES 总分为 15.29 和 15.33,两组间无显著差异。
本研究表明,自体骨加 DBBM 和 FDBA 分别与胶原膜结合,在早期种植体放置后 1 年进行轮廓增强,均可获得稳定的临床和美学效果。