Clinic of Reconstructive Dentistry, University of Zürich, Zürich, Switzerland.
Private Practice, Männedorf, Switzerland.
Clin Oral Implants Res. 2022 Mar;33(3):302-312. doi: 10.1111/clr.13889. Epub 2022 Jan 8.
To assess long-term outcomes of implants placed in conjunction with guided bone regeneration (GBR) with or without recombinant human bone morphogenetic protein-2 (rhBMP-2).
Eleven patients with at least two lateral bone defects (split-mouth design) received a total of 34 implants. The defects were treated with a xenogenic bone substitute with (test) or without (control) rhBMP-2 and covered with a collagen membrane. Eight patients could be reexamined after at least 17 years. Wilcoxon signed-rank tests were performed to assess differences between test and control groups.
The implant survival rate was 100% for all test and control sites. Mean marginal bone levels were 2.51 mm (SD ±1.64) (mesial test), 1.83 mm (SD ±0.93) (mesial control) (p = .055), 2.36 mm (SD ±1.70) (distal test), and 2.13 mm (SD ±0.84) (distal control) (p = 1.000). Compared with the mean values at baseline, a mean bone loss of 1.16 mm (SD ±1.60) (test) and 0.70 mm (SD ±1.02) (control) was found. The mean buccal bone gain after 17 years was 5.38 mm (test) and 3.14 mm (control) based on the comparison between the measurements at the cone beam CT after 17 years and the data from the intraoperative measurements at baseline. Further, mean values for (i) bone thickness ranged from 1.36 to 3.09 mm (test) and 1.18 to 3.39 mm (control) and for (ii) mucosal thickness of 1.24 mm (test) and 1.26 mm (control).
Implants placed in conjunction with GBR applying a xenogenic bone substitute and a collagen membrane with and without the addition of rhBMP-2 demonstrate excellent clinical and radiographic results after at least 17 years.
评估联合使用引导骨再生(GBR)和/或重组人骨形态发生蛋白-2(rhBMP-2)的种植体的长期疗效。
11 名患者(采用双侧分牙设计)共有 34 枚种植体。骨缺损处使用异种骨移植材料(实验组)或不使用异种骨移植材料(对照组),并用胶原膜覆盖。8 名患者至少随访 17 年。采用 Wilcoxon 符号秩检验比较两组之间的差异。
所有实验组和对照组的种植体存留率均为 100%。实验组近中颊侧的平均边缘骨吸收量为 2.51mm(SD ±1.64),对照组为 1.83mm(SD ±0.93)(p=0.055);实验组远中颊侧的平均边缘骨吸收量为 2.36mm(SD ±1.70),对照组为 2.13mm(SD ±0.84)(p=1.000)。与基线相比,实验组平均骨损失为 1.16mm(SD ±1.60),对照组为 0.70mm(SD ±1.02)。17 年后,根据锥形束 CT 检查结果与基线术中测量数据的比较,实验组颊侧骨增量为 5.38mm,对照组为 3.14mm。此外,实验组骨厚度的平均值为 1.36-3.09mm,对照组为 1.18-3.39mm;实验组黏膜厚度的平均值为 1.24mm,对照组为 1.26mm。
至少 17 年后,使用异种骨移植材料和胶原膜联合 GBR 植入种植体,无论是否添加 rhBMP-2,均可获得良好的临床和影像学效果。