Duan Deng Hui, Wang Hom Lay, Wang En Bo
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, 48109, USA.
Beijing Da Xue Xue Bao Yi Xue Ban. 2023 Dec 18;55(6):1097-1104. doi: 10.19723/j.issn.1671-167X.2023.06.022.
To investigate whether the placement of absorbable collagen membrane increase the stability of alveolar ridge contour after guided bone regeneration (GBR) using buccal punch flap.
From June 2019 to June 2023, patients who underwent GBR using buccal punch flap simultaneously with a single implant placement in posterior region (from first premolar to second molar) were divided into coverage group, in which particular bone graft was covered by collagen membrane and non-coverage group. Cone beam CT (CBCT) was taken before surgery (T0), immediately after surgery (T1), and 3-7 months after surgery (T2), and the thickness of the buccal bone plate at different levels (0, 2, 4, and 6 mm) below the smooth-rough interface of the implant (BBT-0, -2, -4, -6) was mea-sured after superimposition of CBCT models using Mimics software.
A total of 29 patients, including 15 patients in coverage group and 14 patients in non-coverage group, were investigated in this study. At T0, T1, and T2, there was no significant difference in BBT between the two groups (>0.05). At T1, BBT-0 was (2.50±0.90) mm in the coverage group and (2.97±1.28) mm in the non-coverage group, with corresponding BBT-2 of (3.65±1.08) mm and (3.58±1.26) mm, respectively. At T2, BBT-0 was (1.22±0.55) mm in the coverage group and (1.70±0.97) mm in the non-coverage group, with corresponding BBT-2 of (2.32±0.94) mm and (2.57±1.26) mm, respectively. From T1 to T2, there were no statistically significant differences in the absolute values [(0.47±0.54)-(1.33±0.75) mm] and percentages [(10.04%±24.81%)-(48.43%±18.32%)] of BBT change between the two groups. The thickness of new bone formation in the buccal bone plate from T0 to T2 ranged from (1.27±1.09) mm to (2.75±2.15) mm with no statistical difference between the two groups at all levels.
In the short term, the GBR using buccal punch flap with or without collagen membrane coverage can effectively repair the buccal implant bone defect. But collagen membrane coverage showed no additional benefit on alveolar ridge contour stability compared with non-membrane coverage.
探讨使用颊侧冲孔瓣引导骨再生（GBR）后，放置可吸收胶原膜是否能增加牙槽嵴轮廓的稳定性。
2019年6月至2023年6月，采用颊侧冲孔瓣同时在后牙区（第一前磨牙至第二磨牙）单颗种植体植入术进行GBR的患者被分为覆盖组（特定骨移植材料用胶原膜覆盖）和非覆盖组。在手术前（T0）、手术后即刻（T1）以及手术后3 - 7个月（T2）进行锥形束CT（CBCT）扫描，使用Mimics软件对CBCT模型进行叠加后，测量种植体光滑 - 粗糙界面下方不同水平（0、2、4和6 mm）处的颊侧骨板厚度（BBT - 0、- 2、- 4、- 6）。
本研究共纳入29例患者，其中覆盖组15例，非覆盖组14例。在T0、T1和T2时，两组间BBT无显著差异（>0.05）。在T1时，覆盖组的BBT - 0为（2.50±0.90）mm，非覆盖组为（2.97±1.28）mm，相应的BBT - 2分别为（3.65±1.08）mm和（3.58±1.26）mm。在T2时，覆盖组的BBT - 0为（1.22±0.55）mm，非覆盖组为（1.70±0.97）mm，相应的BBT - 2分别为（2.32±0.94）mm和（2.57±1.26）mm。从T1到T2，两组间BBT变化的绝对值[（0.47±0.54） - （1.33±0.75）mm]和百分比[（10.04%±24.81%） - （48.43%±18.32%）]无统计学差异。从T0到T2，颊侧骨板新骨形成的厚度范围为（1.27±1.09）mm至（2.75±2.15）mm，各水平两组间均无统计学差异。
短期内，使用颊侧冲孔瓣进行GBR，无论有无胶原膜覆盖，均可有效修复颊侧种植体骨缺损。但与无膜覆盖相比，胶原膜覆盖在牙槽嵴轮廓稳定性方面未显示出额外益处。
