Department of Oral Implantology, Shenzhen Stomatology Hospital (Pingshan) of Southern Medical University, Shenzhen, China.
Department of Prosthodontics, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Stomatological Hospital and Dental School of Tongji University, Shanghai, China.
Clin Oral Investig. 2023 May;27(5):1953-1964. doi: 10.1007/s00784-022-04853-8. Epub 2023 Jan 13.
To assess the clinical efficacy of xenogeneic collagen matrix (XCM) plus apically positioned flap (APF) in augmenting the keratinized mucosa (KM) width (KMW) and thickness (KMT) around posterior mandibular implants and compare it with free gingival graft (FGG) plus APF.
Thirty patients with KMW ≤ 2 mm in the posterior mandibular implant site were randomly allocated to the FGG group (FGG plus APF) or the XCM group (XCM plus APF). Clinical assessments, including KMW and KMT, shrinkage rate of established KM, and peri-implant soft tissue health, were evaluated during a 6-month follow-up. Additionally, the esthetic outcomes and patient-reported postoperative morbidity were investigated.
At 6 months, the KMW measured 3.60 ± 0.79 mm in the FGG group and 3.28 ± 0.96 mm in the XCM group (p = 0.186). Both groups showed a tendency for graft contraction (FGG, 42.11%; XCM, 53.22%). The KMT measured 1.24 ± 0.34 mm in the FGG group and 0.95 ± 0.29 mm in the XCM group, with statistical difference (p = 0.002). No difference in the peri-implant soft tissue health was observed between the two groups (p > 0.05), but the esthetic outcomes were better in the XCM group (p < 0.05).
XCM plus APF rendered a similar clinical efficacy in augmenting KMW as that with FGG plus APF, but with higher shrinkage. XCM plus APF was inferior with respect to FGG plus APF in augmenting KMT. The esthetic outcomes were better with XCM plus APF than FGG plus APF. Clinical relevance XCM plus APF graft was inferior with respect to FGG plus APF in augmenting KMT.
Trial registration number: ChiCTR2200058027 and date: 03/27/2022.
评估异种胶原基质（XCM）加牙槽嵴顶瓣（APF）在增加下颌后牙种植体周围角化黏膜（KM）宽度（KMW）和厚度（KMT）方面的临床疗效，并与游离龈瓣移植（FGG）加 APF 进行比较。
将 30 名下颌后牙种植体位点角化黏膜宽度（KMW）≤2mm 的患者随机分为 FGG 组（FGG 加 APF）或 XCM 组（XCM 加 APF）。在 6 个月的随访期间，对临床评估结果，包括 KMW 和 KMT、已建立的角化黏膜的收缩率以及种植体周围软组织健康状况进行评估。此外，还对美学效果和患者报告的术后并发症进行了调查。
在 6 个月时，FGG 组的 KMW 为 3.60±0.79mm，XCM 组为 3.28±0.96mm（p=0.186）。两组均存在移植物收缩的趋势（FGG 组 42.11%，XCM 组 53.22%）。FGG 组的 KMT 为 1.24±0.34mm，XCM 组为 0.95±0.29mm，差异有统计学意义（p=0.002）。两组间种植体周围软组织健康状况无差异（p>0.05），但 XCM 组的美学效果更好（p<0.05）。
XCM 加 APF 与 FGG 加 APF 增加 KMW 的临床疗效相似，但收缩率更高。XCM 加 APF 在增加 KMT 方面劣于 FGG 加 APF。XCM 加 APF 的美学效果优于 FGG 加 APF。
