Naenni Nadja, Stucki Lukas, Hüsler Jürg, Schneider David, Hämmerle Christoph H F, Jung Ronald E, Thoma Daniel S
Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Korea.
Clin Oral Implants Res. 2021 Aug;32(8):893-904. doi: 10.1111/clr.13764. Epub 2021 Jun 4.
To assess clinical and radiographic outcomes as well as the profilometric contour alterations of peri-implant hard and soft tissues around single implants treated with simultaneous guided bone regeneration (GBR) at 5 years.
Twenty-seven patients presenting with a single tooth gap in the esthetic zone received a two-piece implant. GBR was randomly performed using a resorbable (RES) or a non-resorbable membrane (N-RES) combined with a bone substitute material. Follow-up examinations were performed at baseline (BL = crown insertion), 1 year (FU-1), 3 years (FU-3), and at 5 years (FU-5) including clinical and radiographic parameters as well as profilometric changes. Statistics were performed by means of parametric and nonparametric tests.
At 5 years, 20 out of 27 patients (9 RES, 11 N-RES) were re-examined. Median values for probing depth changed insignificantly between BL and FU-5 in both groups. The median marginal bone levels were located 0.23 mm (0.06; 0.46; RES) and 0.17 mm (0.13;0.28; N-RES) below the implant shoulder at FU-5 (changes over time p < .05). The calculated median profilometric change between BL and FU-5 was -0.28 mm (-0.53;-0.20; RES; p = .016) and -0.24 mm (-0.43;0.08; N-RES; p = .102; intergroup p = .380). The horizontal bone thickness decreased significantly between re-entry and FU-5 for group RES at all measured levels (p < .05) measuring 0.87 mm (0.0; 2.05) at the implant shoulder, whereas the decrease for group N-RES was insignificant (p = .031) with 0 mm (0; 0.84) at the implant shoulder at 5 years.
Implants sites with concomitant GBR using a resorbable or non-resorbable membrane revealed stable marginal bone levels and clinical outcomes. Profilometric changes were clinically negligible over 5 years. The observed change in hard tissue thickness was partially compensated by an increase in soft tissue thickness.
评估在5年时，接受同期引导骨再生（GBR）治疗的单颗种植体周围种植体周围软硬组织的临床和影像学结果以及轮廓测量变化。
27例美学区存在单颗牙间隙的患者接受了两件式种植体。随机使用可吸收（RES）或不可吸收膜（N-RES）联合骨替代材料进行GBR。在基线（BL = 牙冠植入）、1年（FU-1）、3年（FU-3）和5年（FU-5）进行随访检查，包括临床和影像学参数以及轮廓测量变化。通过参数检验和非参数检验进行统计学分析。
5年时，27例患者中的20例（9例RES组，11例N-RES组）接受了复查。两组中，探诊深度的中位数在BL和FU-5之间变化不显著。在FU-5时，边缘骨水平的中位数位于种植体肩部下方0.23 mm（0.06；0.46；RES组）和0.17 mm（0.13；0.28；N-RES组）处（随时间变化p <.05）。计算得出的BL和FU-5之间轮廓测量变化的中位数为-0.28 mm（-0.53；-0.20；RES组；p = 0.016）和-0.24 mm（-0.43；0.08；N-RES组；p = 0.102；组间p = 0.380）。RES组在所有测量水平上，再入路时和FU-5之间水平骨厚度均显著降低（p <.05），在种植体肩部测量为0.87 mm（0.0；2.05），而N-RES组降低不显著（p = 0.031），5年时在种植体肩部为0 mm（0；0.84）。
使用可吸收或不可吸收膜进行同期GBR的种植体部位显示出稳定的边缘骨水平和临床结果。5年内轮廓测量变化在临床上可忽略不计。观察到的硬组织厚度变化部分被软组织厚度增加所补偿。
