Rajan Soumya Anugraha, Ramabhadran Biniraj Kannanganatt, Emmatty Rishi, Paul Tony P, Jose Priya, Ameyaroy Divyasree Kochilat, Variath Preena Thalakottukara, Joseph Mary
Soumya Anugraha Rajan, Department of Clinical Periodontology and Oral Implantology, Royal Dental College, Palakkad, Kerala, India, Phone: +91 9746610048, +91 9447308747, e-mail:
Department of Clinical Periodontology and Oral Implantology, Royal Dental College, Palakkad, Kerala, India.
J Contemp Dent Pract. 2021 Nov 1;22(11):1268-1274.
To compare the mucosal thickness, width of attached gingiva, and extent of coverage achieved with the usage of connective tissue graft, platelet-rich fibrin (PRF) membrane and buccally advanced flap along with bone grafts in the closure of immediate implant site.
Twenty-one sites requiring immediate implants were randomly divided into three groups of seven samples each. The techniques comprised bone grafting in jumping space along with either buccally advanced flap (group A), PRF membrane (group B), or connective tissue graft (group C) to cover the socket. In each group, the extent of socket coverage, mucosal phenotype, and width of attached mucosa achieved were assessed after 3 months and intercompared with initial measurements to identify the best technique in achieving primary tissue closure of immediate implant sites.
Comparative assessment of gain in attached mucosal width had a remarkable difference in all the groups but exhibited no statistical significance among the groups compared. Also, comparative assessment of mucosal thickness and the extent of socket coverage equally indicated a clinical significance among all groups, but failed to achieve any statistical significance.
All the three techniques were found to be equally effective in achieving additional width of attached mucosa around implants, coverage of mucosa at osteotomy sites, and a thicker mucosal phenotype at implant sites. In comparison with one another, no single technique was found to be advantageous over the other.
The commonly used three techniques for socket coverage following the immediate implant placement has been proven to be equally effective. Thus, the selection of the technique to meet the objective of complete closure of an extraction socket along with implant platform is left open to operator skill and operation site, which should consider least traumatic and most feasible technique.
比较在即刻种植位点关闭时,使用结缔组织移植、富血小板纤维蛋白(PRF)膜和颊向推进瓣联合骨移植所实现的黏膜厚度、附着龈宽度及覆盖范围。
21个需要即刻种植的位点被随机分为三组,每组7个样本。技术包括在跳跃间隙处进行骨移植,同时联合颊向推进瓣(A组)、PRF膜(B组)或结缔组织移植(C组)来覆盖牙槽窝。在每组中,3个月后评估牙槽窝覆盖范围、黏膜表型及附着黏膜宽度,并与初始测量值进行比较,以确定实现即刻种植位点一期组织关闭的最佳技术。
附着黏膜宽度增加的比较评估在所有组中均有显著差异,但组间比较无统计学意义。同样,黏膜厚度和牙槽窝覆盖范围的比较评估在所有组中也均显示出临床意义,但未达到任何统计学意义。
发现所有三种技术在增加种植体周围附着黏膜宽度、覆盖截骨部位的黏膜以及在种植位点获得更厚的黏膜表型方面同样有效。相互比较时,未发现单一技术比其他技术更具优势。
即刻种植后常用的三种牙槽窝覆盖技术已被证明同样有效。因此,选择能够实现拔牙窝和种植体平台完全关闭目标的技术,取决于术者的技能和手术部位,应考虑创伤最小且最可行的技术。