Hämmerle C H, Brägger U, Schmid B, Lang N P
Department of Periodontology and Fixed Prosthodontics, University of Bern, Switzerland.
Int J Oral Maxillofac Implants. 1998 Jul-Aug;13(4):522-30.
The aim of this study was to test whether bone could be formed in peri-implant defects at immediate transmucosal implants using guided bone regeneration. Ten patients (median age 48 years) underwent comprehensive dental care including the placement of an implant into an extraction socket immediately following removal of a tooth. An expanded polytetrafluoroethylene membrane and the mucoperiosteal flap were adapted around the neck of the implants, leaving the sites to heal in a transmucosal fashion. During implantation (baseline) and at membrane removal surgery 5 months later, the following clinical measurements from the implant shoulder were assessed at six sites: implant-bone contact (defect depth), level of the alveolar crest, level of the membrane, and distance from the crest to the implant body (defect width). Estimates of the defect volume bordered by the membrane, the implant, and the bony walls were calculated. At baseline, the mean defect depth was 4.7 mm (SD 1.3 mm, range 1 to 14 mm). At membrane removal, the mean defect depth had decreased to 2.1 mm (SD 0.8 mm). Compared to baseline, this decrease was statistically significant (P < .01). The mean increase in bone height at the deepest defect site of each implant was 6.7 mm (SD 3.0 mm), which was significant (P < .01). At baseline, the mean value for the defect volume estimates was 9.45 mm3 (SD 5.75 mm3). At membrane removal, a significant decrease (P < .01) was found. After 5 months, 94% of the area beneath the membrane was filled with new bone. It was concluded that guided tissue regeneration at immediate transmucosal implants is successful in generating bone into peri-implant defects.
本研究的目的是测试在即刻穿黏膜种植体的种植体周围缺损处使用引导骨再生技术是否能够形成骨组织。10例患者（中位年龄48岁）接受了全面的牙科治疗，包括在拔牙后立即将种植体植入拔牙窝。将膨体聚四氟乙烯膜和黏骨膜瓣贴合在种植体颈部周围，使种植部位以穿黏膜方式愈合。在种植时（基线）以及5个月后取出膜的手术时，在六个位点对种植体肩部进行以下临床测量：种植体与骨的接触（缺损深度）、牙槽嵴水平、膜的水平以及从嵴到种植体体部的距离（缺损宽度）。计算由膜、种植体和骨壁界定的缺损体积估计值。基线时，平均缺损深度为4.7 mm（标准差1.3 mm，范围1至14 mm）。取出膜时，平均缺损深度降至2.1 mm（标准差0.8 mm）。与基线相比，这种降低具有统计学意义（P <.01）。每个种植体最深缺损部位的骨高度平均增加6.7 mm（标准差3.0 mm），具有显著性（P <.01）。基线时，缺损体积估计值的平均值为9.45 mm³（标准差5.75 mm³）。取出膜时，发现有显著降低（P <.01）。5个月后，膜下方94%的区域被新骨填充。得出的结论是，即刻穿黏膜种植体的引导组织再生能够成功地在种植体周围缺损处生成骨组织。
