Tarasenko Svetlana, Ashurko Igor, Taschieri Silvio, Repina Svetlana, Esaya N Aleksandr, Corbella Stefano
Quintessence Int. 2020;51(5):374-387. doi: 10.3290/j.qi.a44216.
The aim of the present randomized controlled clinical trial was to evaluate the outcomes of the use of free gingival graft (FGG), of a collagen matrix and of vestibuloplasty to increase the amount of keratinized attached mucosa (KM) before healing abutment placement.
The study was a randomized, parallel-group controlled investigation. All patients were treated to increase the KM width before placement of implant-supported prostheses. The implants were placed 3 to 6 months before the interventions. Three techniques were tested: an apically positioned flap (control group), FGG (test group 1), and use of a collagen matrix (test group 2). Biopsy was performed during healing abutment placement by means of a mucotome.
A total of 63 patients were recruited and treated, and 58 were available for follow-up visits. After 4 weeks, the KM width gain was 1.93 ± 0.85 mm, 4.85 ± 1.11 mm, and 3.03 ± 0.58 mm, respectively, for control group, test group 1, and test group 2. Postoperative pain was significantly higher in the FGG group than in the others. Edema and hyperemia decreased gradually during the first week without significant differences among groups.
Despite the limitations of the study, it was found that FGG was the most effective technique to augment the amount of KM in sites of implant placement. The use of a collagen matrix could be a viable alternative to diminish the intervention's impact on patients' postoperative quality of life.
本随机对照临床试验的目的是评估在植入愈合基台之前，使用游离龈瓣移植术（FGG）、胶原基质和前庭成形术增加角化附着龈（KM）量的效果。
该研究为随机平行组对照研究。所有患者在植入种植体支持的假体之前均接受治疗以增加KM宽度。种植体在干预前3至6个月植入。测试了三种技术：根尖定位瓣（对照组）、FGG（试验组1）和使用胶原基质（试验组2）。在植入愈合基台期间通过切黏膜刀进行活检。
共招募并治疗了63例患者，58例可进行随访。4周后，对照组、试验组1和试验组2的KM宽度增加分别为1.93±0.85mm、4.85±1.11mm和3.03±0.58mm。FGG组术后疼痛明显高于其他组。水肿和充血在第一周逐渐减轻，各组间无显著差异。
尽管该研究存在局限性，但发现FGG是增加种植体植入部位KM量最有效的技术。使用胶原基质可能是减少干预对患者术后生活质量影响的可行替代方法。
