Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain.
J Periodontol. 2022 Jul;93(7):1014-1023. doi: 10.1002/JPER.21-0521. Epub 2022 Jan 25.
A study was made of the dimensional changes in free epithelialized gingival/mucosal grafts (FEGs) used to augment keratinized tissue (KT) at tooth and implant sites, and of the confounders influencing the dynamic changes over 6 months of follow-up.
A prospective cohort interventional study was made of implant and tooth sites needing KT augmentation by means of an apically positioned flap and FEG. Six intraoperative variables were recorded at baseline (T0). In addition, graft width (GW), graft length (GL), and graft dimension (GD) were assessed at 3 weeks (T1), 3 months (T2), and 6 months of follow-up (T3). Univariate and multivariate analyses were performed to explore associations between the demographic and intraoperative variables and the outcomes over the study period.
Based upon an a priori power sample size calculation, a total of 56 consecutive patients were recruited, of which 52 were available for assessment. A total of 73 graft units were included in 122 sites. At T3, the mean change in GD in FEG was 40.21%. In particular, the mean changes in GL and GW were 12.13% and 33.06%, respectively. Statistically significant changes in GD were recorded from T0 to T1 (P < 0.0005) and from T1 to T2 (P < 0.0005), but not from T2 to T3 (P = 0.13). The change in GD at T3 was 33.26% at tooth and 43.11% at implant site level (P = 0.01). Age and GW assessed at T0 proved to be related to the changes in GD and GW in the univariate and multivariate analyses. The univariate analysis showed the avascular area (AA) to be related to the changes in GD and GW at the implant sites, whereas graft thickness (GT) was associated to changes in GD and GW at the tooth sites in the univariate and multivariate analyses.
Free epithelialized grafts are exposed to dimensional changes that result in a reduction of approximately 40% of the original graft dimension-the changes being approximately 10% greater at the implant sites than at the tooth sites (NCT04410614).
本研究旨在探讨游离上皮化龈/黏膜移植物（FEG）用于增加牙和种植体部位角化组织（KT）时的尺寸变化，并分析影响 6 个月随访期间动态变化的混杂因素。
采用前瞻性队列干预研究，对需要通过牙向瓣和 FEG 增加 KT 的种植体和牙齿部位进行研究。在基线（T0）时记录了 6 个术中变量。此外，在 3 周（T1）、3 个月（T2）和 6 个月随访（T3）时评估了移植物宽度（GW）、移植物长度（GL）和移植物尺寸（GD）。进行了单变量和多变量分析，以探讨研究期间人口统计学和术中变量与结果之间的关系。
基于事先计算的样本量，共招募了 56 名连续患者，其中 52 名可用于评估。共有 73 个移植物单位纳入 122 个部位。在 T3 时，FEG 的 GD 平均变化为 40.21%。特别是，GL 和 GW 的平均变化分别为 12.13%和 33.06%。从 T0 到 T1（P<0.0005）和从 T1 到 T2（P<0.0005），GD 均有统计学显著变化，但从 T2 到 T3（P=0.13）则没有。T3 时牙部位的 GD 变化为 33.26%，种植体部位为 43.11%（P=0.01）。在单变量和多变量分析中，T0 时的年龄和 GW 与 GD 和 GW 的变化有关。单变量分析表明，无血管区（AA）与种植体部位的 GD 和 GW 变化有关，而移植物厚度（GT）与牙部位的 GD 和 GW 变化有关，在单变量和多变量分析中均如此。
游离上皮化移植物会发生尺寸变化，导致原始移植物尺寸减少约 40%——种植体部位的变化比牙部位约大 10%（NCT04410614）。
