Clinical efficacy of two vertical soft tissue augmentation techniques for peri-implant crestal bone level stability: A randomized clinical trial.

Algirdas Puisys, Egle Vindasiute-Narbute, Dainius Razukevicius, Samuel Akhondi, German O Gallucci, Ignacio Pedrinaci
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Abstract

Objectives: This study aimed to compare the efficacy of two techniques-acellular dermal matrix (ADM) grafting and tenting technique (TT)-for soft tissue height (STH) augmentation simultaneous to implant placement to minimize peri-implant crestal bone level (CBL) changes.

Methods: Forty patients with a healed single mandibular posterior edentulous site with a thin soft tissue phenotype were enrolled. Twenty patients received simultaneously to implant placement ADM grafting, while the others received submerged healing abutment (TT). Clinical peri-implant soft tissue height and radiographic CBL changes were measured at restoration delivery and 1-year follow-up.

Results: Both techniques effectively increased soft tissue thickness, resulting in a final average STH of 3.4 ± 0.5 mm after augmentation. On average, soft tissue increased by 1.6 ± 0.5 mm in group ADM and by 1.8 ± 0.4 mm in group TT after augmentation. In Group ADM, mesial CBL decreased from 0.4 ± 0.3 mm to 0.1 ± 0.2 mm, and distal CBL decreased from 0.5 ± 0.3 mm to 0.2 ± 0.3 mm over 1 year. In Group TT, mesial CBL remained stable at 0.3 ± 0.2 mm, while distal CBL reduced slightly from 0.5 ± 0.5 mm to 0.3 ± 0.2 mm. Both groups showed minimal changes in CBL, indicating great stability (pmesial = 0.003, pdistal = 0.004). TT was particularly effective in preventing mesial bone loss (pmesial = 0.019). The mesial CBL changes significantly differed between groups (p = 0.019), and not significantly at distal sites (p = 0.944). Neither treatment exhibited significant bone remodeling below the implant shoulder.

Conclusion: This study suggests that both techniques were successful in STH augmentation, and they may effectively reduce peri-implant crestal bone level changes, with TT being slightly superior. TT was more prone to post-surgical complications. This RCT was not registered before participant recruitment and randomization.

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两种垂直软组织增量技术对稳定种植体周围牙槽骨水平的临床疗效:随机临床试验。
研究目的本研究旨在比较两种技术--细胞外基质(ADM)移植和帐篷技术(TT)--在植入种植体的同时增加软组织高度(STH)以减少种植体周围骨嵴水平(CBL)变化的效果:方法:40 位下颌后方缺牙部位愈合且软组织表型较薄的患者入选。20名患者在种植体植入的同时接受了ADM移植,其他患者则接受了浸没式愈合基台(TT)。在修复体交付和 1 年随访时测量临床种植体周围软组织高度和 CBL 影像学变化:结果:两种技术都有效地增加了软组织厚度,增高后的最终平均STH为3.4 ± 0.5 mm。增量后,ADM 组软组织平均增加了 1.6 ± 0.5 毫米,TT 组平均增加了 1.8 ± 0.4 毫米。在 ADM 组中,CBL 中线在 1 年内从 0.4 ± 0.3 mm 下降到 0.1 ± 0.2 mm,CBL 远端从 0.5 ± 0.3 mm 下降到 0.2 ± 0.3 mm。在 TT 组中,中轴 CBL 保持稳定,为 0.3 ± 0.2 毫米,而远轴 CBL 略有下降,从 0.5 ± 0.5 毫米降至 0.3 ± 0.2 毫米。两组的 CBL 变化都很小,这表明其稳定性很好(pmesial = 0.003,pdistal = 0.004)。TT 在防止中轴骨质流失方面尤为有效(pmesial = 0.019)。各组间 CBL 的中线变化有明显差异(p = 0.019),远端则无明显差异(p = 0.944)。两种治疗方法都没有显示出种植体肩部以下有明显的骨重塑:本研究表明,这两种技术在 STH 增量中都是成功的,它们可以有效地减少种植体周围的骨水平变化,其中 TT 稍胜一筹。TT更容易出现术后并发症。该研究在参与者招募和随机分配前未进行注册。
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