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在单颗种植体周围裂开性骨缺损处使用可吸收或不可吸收膜同步引导骨再生后的软硬组织轮廓变化:一项随机对照试验的6个月二次分析

Hard and soft tissue contour changes following simultaneous guided bone regeneration at single peri-implant dehiscence defects using either resorbable or non-resorbable membranes: a 6-month secondary analysis of a randomized controlled trial.

作者信息

Strauss Franz J, Schneider David, Jung Ronald E, Kraus Riccardo, Thoma Daniel S, Naenni Nadja

机构信息

Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.

Faculty of Health Sciences, Universidad Autonoma de Chile, Providencia, Chile.

出版信息

Clin Oral Investig. 2025 Apr 8;29(5):231. doi: 10.1007/s00784-025-06322-4.

Abstract

OBJECTIVES

To compare radiographic and profilometric outcomes 6 months after simultaneous lateral guided bone regeneration (GBR) at single peri-implant dehiscence defects in the anterior region using either resorbable or non-resorbable membranes.

MATERIALS AND METHODS

In 27 patients with a single tooth gap in the anterior region (second premolar to second premolar in the maxilla) a dental implant was placed. Following implant placement GBR was performed at the buccal aspect using randomly either a resorbable collagen membrane (RES) or a non-resorbable titanium-reinforced ePTFE membrane (N-RES). Radiographic (cone-beam computed tomography; CBCT) measurements were performed to assess the buccal bone thickness immediately after the implant placement with simultaneous GBR (baseline) and 6 months later. Buccal soft tissue thickness was assessed by superimposing surface scans taken at baseline and again 6 months later.

RESULTS

A total of 25 datasets could be assessed for the bone dimensions (n = 12, RES; n = 13, N-RES) and 14 datasets for profilometric changes (n = 7, RES; n = 7, N-RES). Group RES showed a significant mean reduction in buccal bone between baseline and 6 months of 0.8 ± 0.4 mm (p = 0.004). The respective mean reduction for group N-RES amounted to 0.1 ± 0.4 mm (p = 0.581). When comparing the buccal bone changes between both group over time, group RES exhibited greater reduction in comparison to group N-RES (intergroup p = 0.017). Profilometric analyses showed a non-significant trend towards soft tissue gain in group RES 0.6 ± 0.7 mm (p = 0.125). Conversely, N-RES group revealed stability, with a mean change of 0.0 ± 0.3 mm (p = 1.000).

CONCLUSIONS

GBR using non-resorbable membranes seems to provide greater dimensional stability of augmented bone at 6 months re-entry and before implant loading compared to resorbable membranes. The lack of differences in the profilometric outcomes and contour changes may be explained by a partial compensation through an increase in soft tissue thickness with resorbable membranes.

CLINICAL RELEVANCE

GBR using non-resorbable membranes may offer greater dimensional stability of augmented bone compared to resorbable membranes. However, these potential benefits may be offset by a compensatory increase in soft tissue thickness when using resorbable membranes.

摘要

目的

比较在前牙区单个种植体周围裂开性缺损处同时使用可吸收或不可吸收膜进行侧向引导骨再生(GBR)6个月后的影像学和轮廓测量结果。

材料与方法

在27例前牙区单牙间隙(上颌第二前磨牙至第二前磨牙)患者中植入一枚牙种植体。种植体植入后,在颊侧使用可吸收胶原膜(RES)或不可吸收钛增强ePTFE膜(N-RES)随机进行GBR。进行影像学(锥形束计算机断层扫描;CBCT)测量,以评估种植体植入同时进行GBR后即刻(基线)及6个月后的颊侧骨厚度。通过叠加基线时和6个月后采集的表面扫描图像评估颊侧软组织厚度。

结果

共可评估25个数据集的骨尺寸(n = 12,RES;n = 13,N-RES)和14个数据集的轮廓测量变化(n = 7,RES;n = 7,N-RES)。RES组在基线和6个月之间颊侧骨平均显著减少0.8±0.4mm(p = 0.004)。N-RES组相应的平均减少量为0.1±0.4mm(p = 0.581)。比较两组随时间的颊侧骨变化时,RES组与N-RES组相比减少更明显(组间p = 0.017)。轮廓测量分析显示RES组软组织增加呈非显著趋势,为0.6±0.7mm(p = 0.125)。相反,N-RES组显示稳定,平均变化为0.0±0.3mm(p = 1.000)。

结论

与可吸收膜相比,使用不可吸收膜进行GBR在6个月再次切开及种植体加载前似乎能为增量骨提供更大的尺寸稳定性。轮廓测量结果和外形变化缺乏差异可能是由于可吸收膜通过软组织厚度增加得到部分补偿。

临床意义

与可吸收膜相比,使用不可吸收膜进行GBR可能为增量骨提供更大的尺寸稳定性。然而,使用可吸收膜时软组织厚度的代偿性增加可能会抵消这些潜在益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f916/11978683/ace75a26502b/784_2025_6322_Fig1_HTML.jpg

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