Zuiderveld Elise G, Raghoebar Gerry M, Vissink Arjan, Gareb Barzi, Meijer Henny J A
Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Restorative Dentistry, Dental School, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
J Periodontol. 2025 May 19. doi: 10.1002/JPER.24-0660.
Soft tissue grafting at dental implant sites has been proposed to enhance esthetic outcomes. A xenogeneic collagen matrix (XCM) was introduced as an alternative grafting material to connective tissue. Only short-term results are yet available.
Sixty patients were treated in a randomized controlled trial with a connective tissue graft (n = 20, CTG group), an XCM (n = 20, XCM group), or received no graft (n = 20, NG group). The grafts were placed at the time of implant placement in a preserved alveolar ridge. The primary outcome was a change in mid-buccal mucosal level (MBML) after 5 years (T). Secondary outcomes were marginal bone level, clinical peri-implant parameters, esthetics, and patient satisfaction.
At T, mean changes in MBML were -0.41 ± 1.20 mm, -0.30 ± 1.22 mm, and -0.61 ± 1.72 mm in the CTG, XCM, and NG groups (p = 0.78), respectively. Also, regarding the secondary outcome variables, no significant between-group differences were observed.
Soft tissue grafting at single implant placement after alveolar ridge preservation, either with a CTG or XCM, does not result in a better esthetic outcome and should not be considered as a standard procedure.
Implant placement in case of a failing tooth is a favorable treatment option. However, since the extraction socket is often associated with a large bone defect, alveolar ridge preservation with bone grafts prior to implant placement is often needed. To compensate for possible soft tissue defects, the application of a CTG or an XCM has been proposed. The question has arisen whether the use of an XCM will give a better outcome than a CTG. Furthermore, are both soft tissue augmentation therapies accompanied by a better esthetic result than performing no soft tissue therapy at all? Therefore, a 5-year study was carried out in which 60 patients with a failing tooth in the frontal region of the upper jaw were treated with removal of the tooth and restoring the gap with bone graft and sealing the socket with mucosagraft from the tuberosity region. At the time of implant placement 5 months thereafter, 20 patients received a CTG, 20 patients received an XCM, and 20 patients no soft tissue therapy. After 5 years, it appeared that there was no difference between the 3 soft tissue treatment procedures. Thus, implant placement combined with soft tissue grafting in preserved alveolar ridges does not result in a better esthetic outcome.
有人提出在牙种植部位进行软组织移植以改善美学效果。一种异种胶原基质（XCM）被引入作为结缔组织的替代移植材料。目前仅有短期结果。
60例患者参与一项随机对照试验，分别接受结缔组织移植（n = 20，CTG组）、XCM移植（n = 20，XCM组）或不进行移植（n = 20，NG组）。在种植体植入时，将移植材料置于保存的牙槽嵴处。主要结局是5年后（T）颊侧中部黏膜水平（MBML）的变化。次要结局包括边缘骨水平、种植体周围临床参数、美学效果和患者满意度。
在T时，CTG组、XCM组和NG组的MBML平均变化分别为-0.41±1.20mm、-0.30±1.22mm和-0.61±1.72mm（p = 0.78）。此外，关于次要结局变量，未观察到组间有显著差异。
在牙槽嵴保存后单颗种植体植入时进行软组织移植，无论是使用CTG还是XCM，都不会带来更好的美学效果，不应被视为标准程序。
对于患牙进行种植体植入是一种理想的治疗选择。然而，由于拔牙窝通常伴有较大的骨缺损，在种植体植入前常需要用骨移植材料进行牙槽嵴保存。为了弥补可能的软组织缺损，有人提出应用CTG或XCM。问题在于使用XCM是否会比CTG产生更好的效果。此外，这两种软组织增量治疗方法是否都比完全不进行软组织治疗具有更好的美学效果？因此，开展了一项为期5年的研究，对上颌前部有患牙的60例患者进行治疗，拔除患牙，用骨移植材料修复间隙，并用结节区的黏膜移植材料封闭拔牙窝。此后5个月进行种植体植入时，20例患者接受CTG，20例患者接受XCM，20例患者不进行软组织治疗。5年后发现，这3种软组织治疗方法之间没有差异。因此，在保存的牙槽嵴中进行种植体植入并结合软组织移植并不会带来更好的美学效果。
