Section of Oral Rehabilitation, Department of Odontology, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark.
Department of Oral and Maxillofacial Surgery, University Hospital, Rigshospitalet, Copenhagen, Denmark.
Clin Oral Implants Res. 2020 Jan;31(1):18-28. doi: 10.1111/clr.13540. Epub 2019 Sep 27.
To evaluate the biological and aesthetic outcome of connective tissue grafting around single-tooth implant replacements in the anterior maxilla after five years.
Nineteen patients (mean age: 22) received 33 implants in combination with bone grafts. After healing, 10 implant sites received facial connective tissue grafts harvested from the palate (test group). The remaining 23 implant sites without soft tissue grafts were used as a control group. The biological outcomes included survival rate, complications, marginal bone level, keratinized mucosa height and soft tissue level. The aesthetic outcomes included soft tissue thickness, spectrophotometric colour of mucosa, 3D facial dimensional changes and professional reported aesthetic outcomes. All data were recorded preoperatively and postoperatively after six months and one, three and five years.
After five years, the survival and success rate of implants was 100% and 93.9% (one aesthetic and one biological complication). The soft tissue level changed significantly more towards the incisal direction in the test than in the control group from one to five years of observation (p = .024). The facial dimension increased significantly more in the test group than in the control group (3 mm marginally: p = .010). The subjective evaluation of mucosa colour was significantly better in the test versus control group (p = .035). Other biological and aesthetic parameters were not significantly different between the test and control group.
Augmentation using a connective tissue graft may result in better mucosal colour match and more facial dimensional gain compared to implant sites without soft tissue grafting.
评估在前上颌单牙种植体修复五年后，使用结缔组织移植进行种植体周围软组织重建的生物学和美学效果。
19 名患者（平均年龄：22 岁）共植入 33 颗种植体，并同期进行骨增量。愈合后，10 个种植位点采用取自腭部的黏膜下结缔组织移植（实验组），23 个未行软组织移植的种植位点作为对照组。评估内容包括：种植体的存活率、并发症、边缘骨吸收、角化黏膜高度和软组织水平。美学效果包括软组织厚度、黏膜比色、3D 面部维度变化和专业评估的美学效果。所有数据均在术前和术后 6 个月、1 年、3 年和 5 年记录。
5 年后，种植体的存活率和成功率均为 100%（美学和生物学并发症各 1 例）。实验组从术后 1 年至 5 年，软组织水平向切端方向的变化明显大于对照组（p=0.024）。实验组的面部维度增加明显大于对照组（3mm 边缘：p=0.010）。实验组的黏膜颜色主观评价明显优于对照组（p=0.035）。实验组和对照组的其他生物学和美学参数无明显差异。
与未行软组织移植的种植体相比，结缔组织移植可使黏膜颜色更匹配，获得更多的面部维度增加。
