Thoma Daniel S, Gasser Thomas J W, Hämmerle Christoph H F, Strauss Franz J, Jung Ronald E
Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
J Periodontol. 2023 Feb;94(2):230-243. doi: 10.1002/JPER.22-0226. Epub 2022 Oct 28.
Interventions to augment the mucosal thickness around dental implants are indicated to optimize esthetics and maintain peri-implant health. However, there is a lack of clinical data on the long-term performance of soft tissue substitutes, such as volume-stable collagen matrix (VCMX), compared to autogenous grafts, such as subepithelial connective tissue grafts (SCTGs). This randomized controlled trial aimed to assess 5-year data on clinical and radiographic outcomes at implant sites previously augmented with VCMX or SCTG.
Twenty patients were randomly assigned for soft tissue augmentation with VCMX or SCTG at single implant sites. Following abutment connection, final restorations were inserted (baseline; BL) and patients were reexamined up to 5 years (FU-5). Measurements included clinical data, marginal bone levels, mucosal thickness, and ridge contour changes. Nonparametric tests and estimates were applied for the statistical analysis.
The median buccal mucosal thickness increased by 0.3 mm (Q1: -0.8; Q3: 1.0) in the VCMX group (P = 0.656) and 0.3 mm (Q1: 0.0; Q3: 1.0) in the SCTG group (P = 0.188) between BL and FU-5 (intergroup P = 0.752), while the ridge contour decreased by a median of -0.3 mm (-0.9; -0.1) (P = 0.078) for VCMX and -0.3 mm (-0.4; -0.2) (P = 0.039) for SCTG (intergroup P = 0.817). Peri-implant health was maintained in both groups with stable clinical and radiographic outcomes and without significant differences between the treatments.
Despite the limited power and considerable dropout rate in the present study, soft tissue augmentation at implant sites with either VCMX or SCTG resulted in similar stable peri-implant tissues, favorable esthetics, and clinically negligible contour changes at 5 years post loading.
旨在增加牙种植体周围黏膜厚度的干预措施有助于优化美观效果并维持种植体周围健康。然而,与自体移植(如上皮下结缔组织移植,SCTG)相比,软组织替代物(如体积稳定胶原基质,VCMX)的长期性能缺乏临床数据。这项随机对照试验旨在评估在先前使用VCMX或SCTG进行增龄的种植部位的5年临床和影像学结果数据。
20名患者被随机分配在单个种植部位使用VCMX或SCTG进行软组织增龄。在连接基台后,植入最终修复体(基线;BL),并对患者进行长达5年的复查(随访5年,FU-5)。测量包括临床数据、边缘骨水平、黏膜厚度和牙槽嵴轮廓变化。采用非参数检验和估计进行统计分析。
在基线和随访5年之间,VCMX组颊侧黏膜厚度中位数增加0.3毫米(四分位数间距1:-0.8;四分位数间距3:1.0)(P = 0.656),SCTG组增加0.3毫米(四分位数间距1:0.0;四分位数间距3:1.0)(P = 0.188)(组间P = 0.752),而VCMX组牙槽嵴轮廓中位数下降-0.3毫米(-0.9;-0.1)(P = 0.078),SCTG组下降-0.3毫米(-0.4;-0.2)(P = 0.039)(组间P = 0.817)。两组均维持了种植体周围健康,临床和影像学结果稳定,治疗之间无显著差异。
尽管本研究的样本量有限且失访率较高,但在种植部位使用VCMX或SCTG进行软组织增龄在加载后5年时均产生了相似的稳定种植体周围组织、良好的美观效果以及临床上可忽略不计的轮廓变化。