Ustaoğlu Gülbahar, Paksoy Tuğçe, Gümüş Kerem Çağlar
Assistant Professor, Department of Periodontology, Faculty of Dentistry, Abant Izzet Baysal University, Bolu, Turkey.
Assistant Professor, Department of Periodontology, Faculty of Dentistry, Beykent University, Istanbul, Turkey.
J Oral Maxillofac Surg. 2020 Jul;78(7):1112-1123. doi: 10.1016/j.joms.2020.02.019. Epub 2020 Feb 21.
The health of peri-implant tissues is associated with the peri-implant soft tissue thickness (STT) and keratinized tissue width (KTW). Resorptive changes in the crestal bone around implant sites will be affected by the STT. The present randomized prospective study compared the effectiveness of titanium-prepared platelet-rich fibrin (T-PRF) with that of connective tissue graft (CTG) on peri-implant STT, KMW, and crestal bone level.
Through simultaneous augmentation of the soft tissue using T-PRF or CTG, 30 implants were placed in 30 patients. The implants were placed in thin, soft tissue areas and thickened simultaneously with a T-PRF membrane in the test group and a CTG in the control group. During surgery (T) and at 3 months postoperatively (T), the KTW and peri-implant STT were measured at 3 points: occlusal part of the alveolar crest (OAC), midbuccal mucosa level (MBML), and 1 mm above the mucogingival junction (MGJ1). The crestal bone changes were evaluated from a periapical radiograph at 3 months postoperatively.
The baseline STT and KTW measurements showed no significant differences between the 2 groups (P < .05). Comparison of the T and T measurements from the 2 groups showed a significant increase in KTW and STT (P < .001). Compared with the test group, the control group showed a highly significant increase in the peri-implant STT at the MBML, MGJ1, and KTW levels (P < .05). No significant difference was found between the 2 groups in terms of the OAC changes (P > .05). No crestal bone loss was observed in any of the dental implants.
Both groups experienced a greater increase in peri-implant STT at the OAC level, and T-PRF can be considered as an autogenous alternative to CTG. Also, peri-implant STT might prevent crestal bone resorption in the osseointegration period.
种植体周围组织的健康与种植体周围软组织厚度(STT)和角化组织宽度(KTW)相关。种植体部位牙槽嵴顶骨的吸收性改变会受到STT的影响。本随机前瞻性研究比较了钛制备富血小板纤维蛋白(T-PRF)与结缔组织移植(CTG)对种植体周围STT、KTW和牙槽嵴顶骨水平的有效性。
通过使用T-PRF或CTG同时进行软组织增量,在30例患者中植入30颗种植体。种植体植入薄的软组织区域,并在试验组用T-PRF膜、对照组用CTG同时进行增厚。在手术时(T)和术后3个月(T),在3个点测量KTW和种植体周围STT:牙槽嵴顶的咬合部分(OAC)、颊侧黏膜中部水平(MBML)以及膜龈联合上方1mm处(MGJ1)。术后3个月从根尖片评估牙槽嵴顶骨的变化。
两组的基线STT和KTW测量值无显著差异(P>0.05)。两组T和T测量值的比较显示KTW和STT有显著增加(P<0.001)。与试验组相比,对照组在MBML、MGJ1和KTW水平的种植体周围STT有极显著增加(P<0.05)。两组在OAC变化方面未发现显著差异(P>0.05)。在任何牙种植体中均未观察到牙槽嵴顶骨吸收。
两组在OAC水平的种植体周围STT均有更大增加,T-PRF可被视为CTG的自体替代物。此外,种植体周围STT可能在骨结合期预防牙槽嵴顶骨吸收。