Department of Periodontology and Implant dentistry, Rambam health care campus, Haifa, Israel.
Rappaport Faculty of Medicine, Technion institute of technology, Haifa, Israel.
Clin Implant Dent Relat Res. 2024 Aug;26(4):742-749. doi: 10.1111/cid.13348. Epub 2024 May 28.
This study aimed to assess radiographic marginal bone changes 22 months post extraction, which is 1 year after implant loading in alveolar ridge preservation (ARP) sites grafted with a combination of collagen-embedded xenogenic bone substitute (DBBM-C) and collagen matrix (CMX), comparing them with implants placed in naturally healed sites.
This randomized controlled clinical trial was conducted over 22 months. Patients who needed a single tooth extraction and subsequent implant placement in nonmolar areas were enrolled. The test group received deproteinized bovine bone mineral with 10% collagen covered by a procaine collagen membrane, while the control group allowed spontaneous healing. Radiographic bone level changes were documented using periapical radiographs at implant placement and follow-up visits (6, 10, and 22 months postextraction). Early implant soft tissue exposure, clinical parameters, and patient-reported outcomes were recorded.
Twenty-two out of 28 participants completed a 22-month follow-up, 9 in the test group and 13 in the control group. At 10-month postextraction follow-up, the mean MBL was 1.01 ± 1.04 mm in the treatment group and 0.81 ± 0.93 mm in the control group (p = 0.804). At 22 months, the mean MBL was 2.09 ± 1.03 mm in the treatment group and 1.58 ± 0.73 mm in the control group (p = 0.339). No statistically significant differences in probing depth (PD) and bleeding on probing (BOP) were found at the 22 -month follow-up as well. Soft tissue mean recession was observed in the control group (0.36 ± 0.84 mm), while no recession was found in the test group (p = 0.2). Early implant soft tissue exposure occurred in 33% of test group participants, while none was observed in the control group (p = 0.047).
One year after implant loading, no significant differences in marginal bone resorption were found between implants placed in ARP-treated and naturally healed sites. However, ARP-treated sites exhibited early implant soft-tissue exposure, suggesting a possible impairment in soft tissue healing.
本研究旨在评估拔牙后 22 个月（即植入物负载后 1 年）的影像学边缘骨变化，比较将胶原蛋白包埋异种骨替代物（DBBM-C）和胶原蛋白基质（CMX）组合应用于牙槽嵴保存（ARP）部位与自然愈合部位植入物的情况。
这是一项为期 22 个月的随机对照临床试验。招募需要在非磨牙区进行单颗牙齿拔除和随后植入的患者。实验组接受脱蛋白牛骨矿物质，表面覆盖 10%胶原蛋白，并用普鲁卡因胶原蛋白膜覆盖，而对照组允许自然愈合。在植入和随访（拔牙后 6、10 和 22 个月）时使用根尖片记录影像学骨水平变化。记录早期种植体软组织暴露、临床参数和患者报告的结果。
28 名参与者中有 22 名完成了 22 个月的随访，其中实验组 9 名，对照组 13 名。拔牙后 10 个月随访时，治疗组的平均 MBL 为 1.01±1.04mm，对照组为 0.81±0.93mm（p=0.804）。22 个月时，治疗组的平均 MBL 为 2.09±1.03mm，对照组为 1.58±0.73mm（p=0.339）。在 22 个月的随访中，探诊深度（PD）和探诊出血（BOP）也没有统计学上的显著差异。对照组软组织平均退缩 0.36±0.84mm，而实验组未发现退缩（p=0.2）。实验组有 33%的患者出现早期种植体软组织暴露，而对照组无此现象（p=0.047）。
植入物负载后 1 年，ARP 处理和自然愈合部位植入物的边缘骨吸收无显著差异。然而，ARP 处理部位出现早期种植体软组织暴露，表明软组织愈合可能受损。
