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一项比较引导骨再生联合结缔组织移植与单独应用于种植体唇颊侧骨缺损重建的随机对照研究:一年期 CBCT 分析。

A randomized controlled study comparing guided bone regeneration with connective tissue graft to re-establish convexity at the buccal aspect of single implants: A one-year CBCT analysis.

机构信息

Vrije Universiteit Brussel (VUB), Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Brussels, Belgium.

Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Dental School, Ghent University, Ghent, Belgium.

出版信息

J Clin Periodontol. 2018 Nov;45(11):1375-1387. doi: 10.1111/jcpe.13006.

Abstract

AIM

To compare guided bone regeneration (GBR) with connective tissue graft (CTG) to re-establish convexity at the buccal aspect of single implants.

MATERIALS AND METHODS

Patients with a single tooth gap in the anterior maxilla and horizontal alveolar defect were enrolled in a single-blind randomized controlled trial. Sites had to demonstrate buccopalatal bone dimension of at least 6 mm prior to surgery to ensure complete embedding of an implant without the need for bone augmentation. All received a single implant and were randomly allocated to the control group (GBR) or the test group (CTG). Cross-sectional CBCT images at t (before surgery), t (2 weeks after surgery) and t (1 year after surgery) were used to evaluate the buccal soft tissue profile (BSP). Secondary outcome variables were buccal bone thickness (BB), buccal soft tissue thickness (BST), vertical bone loss (VBL) and clinical parameters.

RESULTS

Twenty-one patients were included per group (control: 11 females, mean age: 51; test: nine females, mean age: 48). At t , a significant increase in BSP between 0.7 and 1.5 mm was observed in each group (p ≤ 0.010). There was no significant difference between the groups at 1 year (p ≥ 0.126). The increase in BSP in the control group was basically the result of BB gain ranging from 0.69 to 1.15 mm. BSP gain in the test group was the result of an increase in BST ranging from 0.67 to 1.38 mm. VBL did not differ significantly between the groups (p ≥ 0.644). Implants demonstrated healthy clinical conditions with no significant differences between the groups for any of the parameters (p ≥ 0.095).

CONCLUSION

Within the limitations of superimposed CBCT images, GBR and CTG are effective to re-establish convexity at the buccal aspect of single implants in the short term.

摘要

目的

比较引导骨再生(GBR)与结缔组织移植(CTG)在重建单颗种植体颊侧凸度方面的效果。

材料和方法

本单盲随机对照临床试验纳入了上颌前牙区单个牙间隙且伴有水平牙槽骨缺损的患者。所有患者术前颊腭向骨宽度必须至少 6mm,以确保种植体完全埋入而无需进行骨增量。所有患者均植入单个种植体,并随机分为对照组(GBR)和实验组(CTG)。分别于术前(t1)、术后 2 周(t2)和术后 1 年(t3)时进行锥形束 CT (CBCT)横断面扫描,以评估颊侧软组织轮廓(BSP)。次要观察指标包括颊侧骨厚度(BB)、颊侧软组织厚度(BST)、垂直骨吸收(VBL)和临床参数。

结果

每组各纳入 21 例患者(对照组:11 例女性,平均年龄 51 岁;实验组:9 例女性,平均年龄 48 岁)。t1 时,两组的 BSP 均有 0.71.5mm 的显著增加(p≤0.010)。1 年后两组间无统计学差异(p≥0.126)。对照组 BSP 的增加主要是由于 BB 增加 0.691.15mm 所致。实验组 BSP 的增加则是由于 BST 增加 0.67~1.38mm 所致。两组间 VBL 无显著差异(p≥0.644)。所有种植体均表现出健康的临床状况,且两组间任何参数均无显著差异(p≥0.095)。

结论

在 CBCT 重叠影像的限制下,GBR 和 CTG 在短期内均能有效重建单颗种植体颊侧的凸度。

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