Department of Oral & Maxillofacial Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.
Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
Clin Oral Implants Res. 2021 Sep;32(9):1041-1051. doi: 10.1111/clr.13796. Epub 2021 Jul 3.
To test whether early implant placement with alveolar ridge preservation (ARP) results in different esthetic, clinical and patient-reported outcome measures (PROMs) compared with early implant placement without ARP.
Seventy-five patients requiring single tooth extraction in the anterior maxilla were recruited. Following tooth extraction, the patients were randomly allocated to three groups: (a) ARP using demineralized bovine bone mineral containing 10% collagen (DBBM-C) covered by a collagen matrix (CM) (n = 25), (b) ARP using DBBM-C covered with a palatal graft (PG) (n = 25) and (c) spontaneous healing (control) (n = 25). Eight weeks after tooth extraction, a CBCT was taken and early implant placement was performed in all patients. Esthetic, clinical and PROMs were evaluated one year post-loading.
A total of 70 patients were available for re-examination at one year post-loading. The median mid-facial mucosal margin change amounted to -0.02 mm (IQR -0.27-0.46) in the CM group, -0.13 mm (IQR -0.44-0.25) in the PG group and -0.14 mm (IQR -0.29-0.07) in the control group, with no significant differences between the groups. Mean PES scores amounted to 7.0 ± 1.4 in the CM group, 7.1 ± 1.5 in the PG group and 7.3 ± 1.7 in the control group without significant differences between the groups. Plaque, bleeding on probing and probing depth did not differ between treatment groups. PROMs in general revealed no significant differences between the groups.
Early implant placement with ARP using either a collagen matrix or a palatal graft rendered similar esthetic, clinical and PROMs to early implant placement without ARP. When a failing tooth can be replaced with an implant within 2 months after tooth extraction, the added value of ARP might be clinically negligible.
测试与不进行牙槽嵴保存（ARP）的早期种植相比，早期种植加 ARP 是否会产生不同的美学、临床和患者报告的结果测量（PROMs）。
招募了 75 名需要在前上颌进行单颗牙齿拔除的患者。拔牙后，患者被随机分配到三组：（a）使用含 10%胶原蛋白的脱矿牛骨矿物质（DBBM-C）覆盖胶原基质（CM）的 ARP（n=25），（b）使用 DBBM-C 覆盖腭板移植物（PG）的 ARP（n=25）和（c）自发愈合（对照组）（n=25）。拔牙后 8 周，所有患者均行 CBCT 检查，并进行早期种植。在加载后一年评估美学、临床和 PROMs。
共有 70 名患者在加载后一年可进行复查。CM 组的中面部黏膜边缘变化中位数为-0.02mm（IQR-0.27-0.46），PG 组为-0.13mm（IQR-0.44-0.25），对照组为-0.14mm（IQR-0.29-0.07），组间无显著差异。CM 组的平均 PES 评分为 7.0±1.4，PG 组为 7.1±1.5，对照组为 7.3±1.7，组间无显著差异。菌斑、探诊出血和探诊深度在治疗组之间无差异。一般来说，PROMs 组间无显著差异。
使用胶原基质或腭板移植物进行 ARP 的早期种植与不进行 ARP 的早期种植相比，具有相似的美学、临床和 PROMs。如果在拔牙后 2 个月内可以用种植体代替失效的牙齿，那么 ARP 的附加价值在临床上可能微不足道。
