Department for Periodontology, Faculty of Health, Witten/Herdecke University, Witten, Germany.
Division for Periodontology & Peri-Implant Disease, University of Zurich, Zürich, Switzerland.
Clin Implant Dent Relat Res. 2019 Oct;21(5):923-930. doi: 10.1111/cid.12817. Epub 2019 Jul 15.
The achievement and preservation of an adequate amount of soft tissue around implants is a critical factor for the prognosis of the treatment.
To evaluate the effectiveness of a porcine dermal matrix applied during second stage implant surgery for horizontal soft tissue augmentation and preservation of dimensional stability.
Twenty patients (mean age 50.2 ± 11.9 [SD] years) candidate to implant therapy and requiring soft tissue augmentation were recruited in four centers. Augmentation was performed in 24 cases. A porcine dermal matrix was placed into a buccal split-thickness pouch during uncovering surgery. Silicone impressions were taken before surgery (T0), 2 weeks later at suture removal (T2), 6 months (T3), and 24 months (T4) post augmentation. Dimensional changes of soft tissue were evaluated using superimposition of digitalized study casts.
Nineteen patients (23 implants) could be evaluated at 6 months and 13 patients (17 implants) at 24 months. After 6-month follow-up, there was a significant dimensional gain respect to baseline, averaging 0.83 ± 0.64 mm (P < .01). This did not change significantly at 24 months (0.77 ± 0.65 mm, P = .19). The gain was >0.5 mm in 65.2% and 64.7% of the cases, respectively. Soft tissue shrinkage averaged 34.2% ± 77.0% from T2 to T3 (P < .01) and did not change thereafter (P = .39). Shrinkage was more consistent in the posterior mandible than in the maxilla, but not significantly (P = .23 at 6-month and .36 at 24-month). No adverse events occurred.
Within the limitations of this prospective case series, the use of a porcine dermal matrix may provide consistent soft tissue augmentation that maintains up to 24-month follow-up, although graft shrinkage may occur in the first 6 months, depending on the location of surgery.
在种植体周围获得并维持足够量的软组织是治疗预后的关键因素。
评估在二期种植手术中应用猪真皮基质进行水平软组织增量和维持体积稳定性的效果。
在四个中心共招募了 20 名(平均年龄 50.2 ± 11.9 [SD] 岁)有种植治疗适应证且需要软组织增量的患者。24 例患者进行了增量。在暴露手术中,将猪真皮基质置于颊侧分层袋中。在术前(T0)、缝线拆除后 2 周(T2)、6 个月(T3)和 24 个月(T4)时进行硅橡胶印模。通过数字化研究模型的叠加评估软组织的尺寸变化。
19 名患者(23 个种植体)可在 6 个月时进行评估,13 名患者(17 个种植体)可在 24 个月时进行评估。6 个月随访时,与基线相比,平均软组织有 0.83 ± 0.64 mm 的显著增量(P <.01)。在 24 个月时,这一数值没有显著变化(0.77 ± 0.65 mm,P =.19)。分别有 65.2%和 64.7%的病例增量大于 0.5 mm。从 T2 到 T3 时,软组织收缩平均为 34.2% ± 77.0%(P <.01),此后无变化(P =.39)。下颌后牙区的收缩比上颌更一致,但无统计学差异(6 个月时 P =.23,24 个月时 P =.36)。无不良事件发生。
在本前瞻性病例系列研究的限制范围内,使用猪真皮基质可能提供一致的软组织增量,在 24 个月的随访中保持稳定,尽管根据手术部位的不同,在最初 6 个月可能会发生移植物收缩。