Simoni Malushi Eriselda, Isufi Renato, Kadaifciu Denis
Oral and Maxillofacial Surgery, University Dental Clinic, Tirana, ALB.
Oral Surgery, University Dental Clinic, Tirana, ALB.
Cureus. 2023 May 14;15(5):e38988. doi: 10.7759/cureus.38988. eCollection 2023 May.
Background Guided bone regeneration (GBR) is used to influence on stabilization of dental implants in patients with insufficient bone quantity and anatomical problems. But many studies using GBR resulted in divergent results according to the efficiency of new bone quantity formation and implant survival. This research aimed to study the effects of GBR on the increase of bone quantity and short-term stabilization of dental implants in patients with insufficient bone support. Methodology The study included 26 patients that underwent the procedure for 40 dental implants from September 2020 to September 2021. In each case, the vertical bone support was intraoperatively measured, through the MEDIDENT Italia paradontal millimetric probe (Medident Italia, Carpi, Italy). The vertical bone defect was considered when the mean vertical depth between the abutment junction and the marginal bone was greater than 1mm up to 8mm. In the group with the presence of the vertical bone defect, GBR technique was used during the procedure of dental implants realized with synthetic bone graft, resorbable membrane, and platelet-rich fibrin (PRF), and the group was considered the study (GBR) group. The group of patients with no vertical bone defects (less than 1mm) and no need for any GBR technique use was considered the control (no-GBR) group. The bone support was evaluated again intraoperatively after six months in both groups when the healing abutments were positioned. The vertical bone defect for each group in baseline and after six months is presented as mean±SD and compared using a t-test. A t-test for Equality of Means was used to calculate the mean depth difference (MDD) between baseline and six months values in each group (GBR and no-GBR) and also between both groups. P-value ≤ 0.05 is considered statistically significant. Results Overall 40 dental implants were placed, 20 of them were included in the GBR group and 20 in the no-GBR group. In the GBR group, a statistically significant greater mean vertical bone defect in baseline (day 1), compared to the no-GBR group was found (-4.46±2.76 vs -0.27±0.22; MDD = -4.19 [-5.44 to -2.94] p<0.001). At six months of follow-up in the GBR group, a new bone around the implant was formed, presenting a significantly lower bone defect compared to the baseline measure (-0.39±0.43 vs -4.46±2.76; MDD = -4.07 mm [-5.37 to -2.78] p<0.001). In six months, no statistically significant difference between GBR and no-GBR group in bone support was found (-0.39±0.43 vs -0.27±0.22; MDD = -0.19 [-0.40 to -0.03] p=0.10). In each group, only one implant failure was observed. Conclusions The use of GBR showed an important reduction of vertical depth defect between healing abutment and marginal bone predisposing similar short-term stability and survival of dental implants. The use of GBR techniques could be essential in the stabilization of dental implants in patients with insufficient bone support.
引导骨再生(GBR)用于改善骨量不足和存在解剖问题患者的牙种植体稳定性。但许多使用GBR的研究在新骨形成效率和种植体存活率方面得出了不同结果。本研究旨在探讨GBR对骨量不足患者骨量增加及牙种植体短期稳定性的影响。方法:本研究纳入了2020年9月至2021年9月期间接受40颗牙种植手术的26例患者。术中使用MEDIDENT Italia牙周毫米探针(意大利Medident公司,卡尔皮,意大利)测量每例患者的垂直骨支持情况。当基台连接处与边缘骨之间的平均垂直深度大于1mm至8mm时,视为存在垂直骨缺损。在存在垂直骨缺损的组中,在牙种植手术过程中使用GBR技术,采用合成骨移植、可吸收膜和富血小板纤维蛋白(PRF),该组被视为研究(GBR)组。无垂直骨缺损(小于1mm)且无需使用任何GBR技术的患者组被视为对照(非GBR)组。两组在植入愈合基台6个月后再次进行术中骨支持评估。每组基线和6个月后的垂直骨缺损以平均值±标准差表示,并采用t检验进行比较。使用均值相等t检验计算每组(GBR组和非GBR组)基线和6个月值之间以及两组之间的平均深度差异(MDD)。P值≤0.05被认为具有统计学意义。结果:共植入40颗牙种植体,其中20颗纳入GBR组,20颗纳入非GBR组。GBR组在基线(第1天)时的平均垂直骨缺损在统计学上显著大于非GBR组(-4.46±2.76 vs -0.27±0.22;MDD = -4.19 [-5.44至-2.94],p<0.001)。在GBR组随访6个月时,种植体周围形成了新骨,与基线测量相比,骨缺损显著降低(-0.39±0.43 vs -4.46±2.76;MDD = -4.07mm [-5.37至-2.78],p<0.001)。6个月时,GBR组和非GBR组在骨支持方面未发现统计学上的显著差异(-0.39±0.43 vs -0.27±0.22;MDD = -0.19 [-0.40至-0.03],p = 0.10)。每组均仅观察到1例种植体失败。结论:使用GBR显示愈合基台与边缘骨之间的垂直深度缺损显著减少,使牙种植体具有相似的短期稳定性和存活率。GBR技术的应用对于骨支持不足患者的牙种植体稳定可能至关重要。