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使用钛增强致密聚四氟乙烯(d-PTFE)膜或钛网及胶原膜进行垂直牙槽嵴增高术:一项随机临床试验的3年结果

Vertical ridge augmentation with Ti-reinforced dense polytetrafluoroethylene (d-PTFE) membranes or Ti-meshes and collagen membranes: 3-year results of a randomized clinical trial.

作者信息

Cucchi Alessandro, Bettini Sofia, Ghensi Paolo, Fiorino Antonino, Corinaldesi Giuseppe

机构信息

Private Practice, Bologna, Italy.

Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.

出版信息

Clin Implant Dent Relat Res. 2023 Apr;25(2):352-369. doi: 10.1111/cid.13173. Epub 2023 Jan 16.

Abstract

BACKGROUND

The present study aimed to evaluate hard and soft tissue parameters around implants placed in augmented posterior mandible, comparing Ti-reinforced d-PTFE membranes with Ti-meshes covered with collagen membranes, after 3 years of follow-up.

MATERIALS AND METHODS

Forty eligible patients were randomly assigned to group A (Ti-reinforced d-PTFE membrane) or group B (mesh covered with collagen membrane) for vertical ridge augmentation (VRA) and simultaneous implants. Implants were evaluated using specific peri-implant parameters for bone and soft tissues: probing pocket depth (PPD), modified plaque index (mPI), bleeding on probing (BoP), modified gingival index (mGI), thickness of keratinized tissue (tKT), width of keratinized tissue (wKT), fornix depth (FD), peri-implant bone level (PBL), interproximal bone peaks (IBP), marginal bone loss (MBL), interproximal bone loss (IBL).

RESULTS

A total of 28 patients with 79 implants were evaluated after 3 years of follow-up. The mean value of MBL was 0.70 mm (group A = 0.73 mm; group B = 0.71 mm), while mean IBL was 0.54 mm (group A = 0.64 mm; group B = 0.40 mm). The treatment with meshes resulted not inferior to PTFE and their clinical results appeared similar. A strong correlation between PBL and IBP was confirmed. Both study groups showed an increase of tKT and wKT values.

CONCLUSION

In the posterior mandible, VRA using both techniques provides stable PBLs up to 3 years. A correct soft tissue management and a strict professional oral hygiene protocol play a crucial role on peri-implant health over time.

摘要

背景

本研究旨在评估在经过3年随访后,植入在下颌后牙区骨增量部位的种植体周围的软硬组织参数,比较钛增强型双层聚四氟乙烯(d-PTFE)膜与覆盖有胶原膜的钛网。

材料与方法

40名符合条件的患者被随机分配到A组(钛增强型d-PTFE膜)或B组(覆盖有胶原膜的网),进行垂直骨增量(VRA)并同期植入种植体。使用特定的种植体周围骨和软组织参数对种植体进行评估:探诊深度(PPD)、改良菌斑指数(mPI)、探诊出血(BoP)、改良牙龈指数(mGI)、角化组织厚度(tKT)、角化组织宽度(wKT)、穹窿深度(FD)、种植体周围骨水平(PBL)、邻间骨嵴顶(IBP)、边缘骨吸收(MBL)、邻间骨吸收(IBL)。

结果

经过3年随访,共评估了28名患者的79颗种植体。MBL的平均值为0.70毫米(A组 = 0.73毫米;B组 = 0.71毫米),而平均IBL为0.54毫米(A组 = 0.64毫米;B组 = 0.40毫米)。使用网的治疗效果不低于PTFE,且临床结果相似。证实PBL和IBP之间存在强相关性。两个研究组的tKT和wKT值均有所增加。

结论

在下颌后牙区,使用这两种技术进行VRA在3年内可提供稳定的PBL。随着时间的推移,正确的软组织管理和严格的专业口腔卫生方案对种植体周围健康起着至关重要的作用。

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