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软组织增量对即刻种植位点组织保存的临床疗效:一项随机对照试验。

Clinical efficacy of soft-tissue augmentation on tissue preservation at immediate implant sites: A randomized controlled trial.

机构信息

Department of Periodontics and Dental Hygiene, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas, USA.

Department of Diagnostic and Biomedical Sciences, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas, USA.

出版信息

J Clin Periodontol. 2023 Jul;50(7):1010-1020. doi: 10.1111/jcpe.13816. Epub 2023 Apr 13.

Abstract

AIM

This randomized controlled trial aimed to investigate the efficacy of soft-tissue augmentation (STA) with a subepithelial connective tissue graft (SCTG) or an acellular dermal matrix (ADM) on reducing tissue alterations at an immediate implant site.

MATERIALS AND METHODS

This trial had three groups: (i) immediate implant with SCTG (ICT group); (ii) immediate implant with ADM (IAD group); (iii) immediate implant without STA (control group). Forty-six patients were randomly assigned to each group. Implants were placed at the maxillary anterior or premolar areas and restored after the 6-month visit. Clinical outcomes, including buccal soft-tissue contour, peri-implant mucosal level, soft-tissue thickness and keratinized tissue width, were measured at baseline and at 3-, 6- and 12-month follow-up visits. Radiographic bone levels were measured at baseline and at 6- and 12-month follow-up visits. Patient-reported outcomes were also collected.

RESULTS

STA procedures increased peri-implant mucosal thickness and maintained buccal soft-tissue contours. Compared to the control group, STA groups did not prevent peri-implant mucosal recession or interproximal bone resorption. Generally, no significant differences in clinical outcomes were detected between the ICT and IAD groups. Most patients were highly satisfied with the immediate implant procedure and outcomes without significant differences between groups.

CONCLUSIONS

STA at immediate implant sites enhanced soft-tissue thickness and maintained soft-tissue contours but did not prevent peri-implant mucosal recession or interproximal bone resorption. Long-term follow-up should be performed since these results were reported for only up to 1 year.

摘要

目的

本随机对照试验旨在研究上皮下结缔组织移植物(SCTG)或脱细胞真皮基质(ADM)的软组织增量(STA)在减少即刻种植体部位组织改变方面的疗效。

材料和方法

本试验分为三组:(i)SCTG 即刻种植(ICT 组);(ii)ADM 即刻种植(IAD 组);(iii)无 STA 的即刻种植(对照组)。将 46 例患者随机分配至每组。在上颌前牙或前磨牙区域植入种植体,在 6 个月就诊时进行修复。在基线和 3、6 和 12 个月随访时测量临床结果,包括颊侧软组织轮廓、种植体周围黏膜水平、软组织厚度和角化组织宽度。在基线和 6 个月和 12 个月随访时测量放射学骨水平。还收集了患者报告的结果。

结果

STA 程序增加了种植体周围黏膜的厚度并维持了颊侧软组织轮廓。与对照组相比,STA 组并未预防种植体周围黏膜退缩或近中骨吸收。一般来说,ICT 组和 IAD 组之间的临床结果没有显著差异。大多数患者对即刻种植手术和结果非常满意,组间无显著差异。

结论

在即刻种植部位进行 STA 可增加软组织厚度并维持软组织轮廓,但不能预防种植体周围黏膜退缩或近中骨吸收。由于这些结果仅报告了 1 年,因此应进行长期随访。

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