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种植体周围组织变化:牙槽嵴保存位点植入物植入后 1 年的随访随机对照临床试验。

Tissue changes around dental implants installed in alveolar ridge preservation sites: A 1-year follow-up randomized controlled clinical trial.

机构信息

Department of Periodontology and Implant dentistry, Rambam health care campus, Haifa, Israel.

Rappaport Faculty of Medicine, Technion institute of technology, Haifa, Israel.

出版信息

Clin Implant Dent Relat Res. 2024 Aug;26(4):742-749. doi: 10.1111/cid.13348. Epub 2024 May 28.

Abstract

OBJECTIVE

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.

METHODS

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.

RESULTS

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).

CONCLUSION

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.

摘要

目的

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。

方法

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。

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)。

结论

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。

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