Severi Mattia, Chiara Franzini, Simonelli Anna, Scapoli Chiara, Trombelli Leonardo
Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.
Operative Unit of Dentistry, Azienda Unità Sanitaria Locale (AUSL), Ferrara, Italy.
Clin Oral Implants Res. 2025 Apr;36(4):481-493. doi: 10.1111/clr.14400. Epub 2025 Jan 19.
To evaluate the effectiveness of Sub-periosteal Peri-implant Augmented Layer (SPAL) technique performed with deproteinized bovine bone mineral (DBBM), delivered either as particulate (pDBBM) or block (bDBBM), in correcting a peri implant bone dehiscence (PIBD). Implants showing a thick (≥ 2 mm) peri-implant buccal bone plate (PBBP) at placement were also examined.
Patients with a PIBD ≥ 1 mm, treated with SPAL with either pDBBM (SPAL) or bDBBM (SPAL), and patients with an implant showing a PBBP ≥ 2 mm at insertion (CONTROL) were included. Re-entry was performed either at 6 months (SPAL groups) or 3 months (CONTROL). The rate of patients presenting no PIBD at re-entry was the primary outcome. Bone dehiscence height (BDH) and width (BDW), thickness of buccal tissues (BTT) and marginal bone level (MBL) were secondary outcomes.
Thirty-nine implants in 39 patients (14 in SPAL,14 in SPAL and 11 in CONTROL) were analyzed. No PIBD were found in SPAL whereas in SPAL one PIBD was present. Two patients in CONTROL presented a PIBD. A reduction in both BDH and BDW was observed in both SPAL (2.7 ± 1.6 mm for BDH and 3.9 ± 0.2 mm for BDW) and SPAL (2.5 ± 1.8 mm for BDH and 3.8 ± 1.1 mm for BDW). SPAL showed a higher BTT than SPAL at re-entry (3.6 ± 1.3 mm for SPAL and 2.6 ± 0.6 mm for SPAL, p = 0.0160). All groups showed similar MBL.
SPAL performed with either a pDBBM or bDBBM is similarly effective in correcting a PIBD as well as in increasing BTT.
评估采用脱蛋白牛骨矿物质（DBBM）以颗粒形式（pDBBM）或块状形式（bDBBM）进行的骨膜下种植体增强层（SPAL）技术在纠正种植体周围骨裂开（PIBD）方面的有效性。还对植入时显示种植体颊侧骨板（PBBP）厚度≥2毫米的种植体进行了检查。
纳入PIBD≥1毫米、接受pDBBM（SPAL）或bDBBM（SPAL）的SPAL治疗的患者，以及植入时PBBP≥2毫米的种植体患者（对照组）。再入路手术在6个月时（SPAL组）或3个月时（对照组）进行。再入路时无PIBD的患者比例为主要观察指标。骨裂开高度（BDH）和宽度（BDW）、颊侧组织厚度（BTT）和边缘骨水平（MBL）为次要观察指标。
分析了39例患者的39颗种植体（SPAL组14颗、SPAL组14颗、对照组11颗）。SPAL组未发现PIBD，而SPAL组有1例PIBD。对照组有2例患者出现PIBD。SPAL组（BDH为2.7±1.6毫米，BDW为3.9±0.2毫米）和SPAL组（BDH为2.5±1.8毫米，BDW为3.8±1.1毫米）的BDH和BDW均有所降低。再入路时，SPAL组的BTT高于SPAL组（SPAL组为3.6±1.3毫米，SPAL组为2.6±0.6毫米，p = 0.0160）。所有组的MBL相似。
采用pDBBM或bDBBM进行的SPAL技术在纠正PIBD以及增加BTT方面同样有效。
