Ibrahim Ammar, Saymeh Rowaida, Yosef Basima
Department of Periodontology, Faculty of Dental Medicine, Damascus University, Damascus, SYR.
Department of Histopathology, Faculty of Dentistry, Tishreen University, Latakia, SYR.
Cureus. 2024 Aug 6;16(8):e66263. doi: 10.7759/cureus.66263. eCollection 2024 Aug.
Background Soft tissue augmentation is a critical procedure in dental implantology aimed at improving peri-implant health and aesthetics. Various materials are used for this purpose, but their comparative effectiveness remains under-researched. This study aimed to evaluate the effects of soft tissue augmentation utilizing two different materials after tooth extraction on peri-implant clinical and radiographic outcomes. Methodology A randomized controlled trial was conducted with 30 participants requiring extraction of non-restorable mandibular posterior teeth. Participants were randomly assigned to receive connective tissue graft (CTG), Fibro-gide (FG), or spontaneous healing (SH) in a 1:1:1 allocation ratio. Two months post-treatment, dental implants were placed. Six months after the functional loading of the dental implant, peri-implant health was assessed using the Plaque Accumulation Index, bleeding on probing (BOP), pocket depth, mucosal recession, and marginal bone level. Results At the six-month follow-up, the SH group exhibited significantly higher Plaque Index and BOP percentages (6.43 ± 1.23 and 70%, respectively) compared to the CTG group (0.40 ± 0.32 and 8.3%, respectively) and FG group (0.45 ± 0.44 and 9.7%, respectively). The mean probing pocket depth was also significantly higher in the control group (5.13 ± 0.64 mm), while the CTG and FG groups showed minimal changes (3.83 ± 0.39 mm for both groups). Additionally, gingival recession was higher in the control group (0.65 ± 0.18 mm) compared to the CTG and FG groups (0.03 ± 0.08 mm for both groups). Radiographic analysis revealed greater marginal bone loss in the control group (0.40 ± 0.05 mm) compared to the CTG and FG groups, which demonstrated minimal bone loss (0.17 ± 0.08 mm and 0.20 ± 0.00 mm, respectively). Conclusions The study findings indicate that FG is as effective as CTG in maintaining peri-implant health, outperforming SH. These findings suggest that FG can be a viable alternative to CTG in soft tissue augmentation after tooth extraction, offering a new option for clinicians in the management of extraction sites before dental implant placement.
软组织增量术是牙种植学中的一项关键手术，旨在改善种植体周围的健康状况和美观效果。为此使用了多种材料，但其相对有效性仍研究不足。本研究旨在评估拔牙后使用两种不同材料进行软组织增量对种植体周围临床和影像学结果的影响。
对30名需要拔除无法修复的下颌后牙的参与者进行了一项随机对照试验。参与者被随机分配，以1:1:1的分配比例接受结缔组织移植（CTG）、Fibro-gide（FG）或自然愈合（SH）。治疗后两个月植入牙种植体。在牙种植体功能加载六个月后，使用菌斑积聚指数、探诊出血（BOP）、牙周袋深度、牙龈退缩和边缘骨水平评估种植体周围健康状况。
在六个月的随访中，与CTG组（分别为0.40±0.32和8.3%）和FG组（分别为0.45±0.44和9.7%）相比，SH组的菌斑指数和BOP百分比显著更高（分别为6.43±1.23和70%）。对照组的平均探诊牙周袋深度也显著更高（5.13±0.64毫米），而CTG组和FG组变化最小（两组均为3.83±0.39毫米）。此外，与CTG组和FG组（两组均为0.03±0.08毫米）相比，对照组的牙龈退缩更高（0.65±0.18毫米）。影像学分析显示，与CTG组和FG组相比，对照组的边缘骨吸收更大（0.40±0.05毫米），CTG组和FG组的骨吸收最小（分别为0.17±0.08毫米和0.20±0.00毫米）。
研究结果表明，FG在维持种植体周围健康方面与CTG一样有效，优于SH。这些发现表明，FG可以成为拔牙后软组织增量中CTG的可行替代方案，为临床医生在植入牙种植体前处理拔牙位点提供了新的选择。
