A Randomized Controlled Trial on the Timing of Soft-Tissue Augmentation in Immediate Implant Placement: Hard-Tissue Changes and Clinical Outcome

IF 5.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Journal of Clinical Periodontology Pub Date : 2024-09-01 DOI:10.1111/jcpe.14060

Jan Cosyn, Thibault Struys, Pieter-Jan Van Hove, Stefanie De Buyser, Thomas De Bruyckere

{"title":"A Randomized Controlled Trial on the Timing of Soft-Tissue Augmentation in Immediate Implant Placement: Hard-Tissue Changes and Clinical Outcome","authors":"Jan Cosyn, Thibault Struys, Pieter-Jan Van Hove, Stefanie De Buyser, Thomas De Bruyckere","doi":"10.1111/jcpe.14060","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aim</h3>\n \n <p>To assess the impact of the timing of soft-tissue augmentation (STA) on mean buccal bone changes following immediate implant placement (IPP) in the anterior maxilla.</p>\n </section>\n \n <section>\n \n <h3> Materials and Methods</h3>\n \n <p>Patients with a failing tooth and intact buccal bone wall in the anterior maxilla (15–25) were enrolled in this randomized controlled trial. Following single IIP and socket grafting, they were randomly allocated to the control group (immediate STA performed during the same surgical procedure) or the test group (delayed STA performed 3 months later). Implants were placed with a surgical guide and immediately restored with an implant-supported provisional crown. Changes in bone dimensions were assessed using superimposed CBCT images taken prior to surgery and at 1-year follow-up. Clinical outcomes were registered at 1-year follow-up.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Twenty patients were randomized to each group (control: 16 females, 4 males, mean age 57.6; test: 9 females, 11 males, mean age 54.2). Ten patients in the control group and 13 patients in the test group had a thick bone wall phenotype. Estimated marginal mean horizontal buccal bone loss at 1 mm below the implant shoulder was −0.553 and −0.898 mm for the control and test group, respectively. The estimated mean difference of 0.344 mm in favour of the control group was not significant (95% CI: −0.415 to 1.104; <i>p</i> = 0.363). Also at all other horizontal and vertical levels, no significant differences could be observed between the groups. The combination of socket grafting and STA enabled counteraction of any buccal soft-tissue loss (≥ 0 mm) at 1 mm below the implant shoulder in 82% of the patients in the control group and in 75% of the patients in the test group (<i>p</i> = 1.000). The clinical outcome was favourable in both groups, yet implants in the control group demonstrated slightly less marginal bone loss (median difference 0.20 mm; 95% CI: 0.00–0.44; <i>p</i> = 0.028).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>In patients with an intact and mainly thick buccal bone wall in the anterior maxilla, the timing of STA following IIP had no significant impact on mean buccal bone loss.</p>\n </section>\n \n <section>\n \n <h3> Trial Registration</h3>\n \n <p>ClinicalTrials.gov identifier: NCT05537545</p>\n </section>\n </div>","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":null,"pages":null},"PeriodicalIF":5.8000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Periodontology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jcpe.14060","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}

引用次数: 0

Abstract

Aim

To assess the impact of the timing of soft-tissue augmentation (STA) on mean buccal bone changes following immediate implant placement (IPP) in the anterior maxilla.

Materials and Methods

Patients with a failing tooth and intact buccal bone wall in the anterior maxilla (15–25) were enrolled in this randomized controlled trial. Following single IIP and socket grafting, they were randomly allocated to the control group (immediate STA performed during the same surgical procedure) or the test group (delayed STA performed 3 months later). Implants were placed with a surgical guide and immediately restored with an implant-supported provisional crown. Changes in bone dimensions were assessed using superimposed CBCT images taken prior to surgery and at 1-year follow-up. Clinical outcomes were registered at 1-year follow-up.

Results

Twenty patients were randomized to each group (control: 16 females, 4 males, mean age 57.6; test: 9 females, 11 males, mean age 54.2). Ten patients in the control group and 13 patients in the test group had a thick bone wall phenotype. Estimated marginal mean horizontal buccal bone loss at 1 mm below the implant shoulder was −0.553 and −0.898 mm for the control and test group, respectively. The estimated mean difference of 0.344 mm in favour of the control group was not significant (95% CI: −0.415 to 1.104; p = 0.363). Also at all other horizontal and vertical levels, no significant differences could be observed between the groups. The combination of socket grafting and STA enabled counteraction of any buccal soft-tissue loss (≥ 0 mm) at 1 mm below the implant shoulder in 82% of the patients in the control group and in 75% of the patients in the test group (p = 1.000). The clinical outcome was favourable in both groups, yet implants in the control group demonstrated slightly less marginal bone loss (median difference 0.20 mm; 95% CI: 0.00–0.44; p = 0.028).

Conclusion

In patients with an intact and mainly thick buccal bone wall in the anterior maxilla, the timing of STA following IIP had no significant impact on mean buccal bone loss.

Trial Registration

ClinicalTrials.gov identifier: NCT05537545

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

即刻种植体植入中软组织增量时机的随机对照试验：硬组织变化与临床效果。

目的：评估上颌前牙即刻种植体植入（IPP）后软组织增量（STA）时机对平均颊骨变化的影响：本随机对照试验招募了上颌前牙失败且颊骨壁完整的患者（15-25 人）。在单颗 IIP 和牙槽移植后，他们被随机分配到对照组（在同一手术过程中立即进行 STA）或试验组（3 个月后延迟进行 STA）。使用手术导板植入种植体，并立即用种植体支撑的临时牙冠进行修复。使用手术前和随访 1 年时所拍摄的 CBCT 叠加图像对骨尺寸的变化进行评估。结果：每组随机分配 20 名患者（对照组：16 名女性，4 名男性，平均年龄 57.6 岁；试验组：9 名女性，11 名男性，平均年龄 54.2 岁）。对照组和测试组分别有 10 名和 13 名患者具有厚骨壁表型。对照组和测试组在种植体肩部下方 1 毫米处的边缘平均水平颊骨损失估计分别为-0.553 毫米和-0.898 毫米。对照组的估计平均值为 0.344 毫米，差异不显著（95% CI：-0.415 至 1.104；P = 0.363）。此外，在所有其他水平和垂直水平上，两组之间也没有明显差异。在对照组和试验组中，分别有 82% 和 75% 的患者在种植体肩部下方 1 mm 处的颊软组织缺损（≥ 0 mm）得到了修复（p = 1.000）。两组患者的临床结果都很好，但对照组的种植体边缘骨质流失略少（中位数差异为 0.20 毫米；95% CI：0.00-0.44；p = 0.028）：结论：对于上颌前牙颊骨壁完整且主要较厚的患者，IIP后的STA时机对平均颊骨损失没有显著影响：试验注册：ClinicalTrials.gov identifier：NCT05537545。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Journal of Clinical Periodontology 医学-牙科与口腔外科

CiteScore

13.30

自引率

10.40%

发文量

175

审稿时长

3-8 weeks

期刊介绍： Journal of Clinical Periodontology was founded by the British, Dutch, French, German, Scandinavian, and Swiss Societies of Periodontology. The aim of the Journal of Clinical Periodontology is to provide the platform for exchange of scientific and clinical progress in the field of Periodontology and allied disciplines, and to do so at the highest possible level. The Journal also aims to facilitate the application of new scientific knowledge to the daily practice of the concerned disciplines and addresses both practicing clinicians and academics. The Journal is the official publication of the European Federation of Periodontology but wishes to retain its international scope. The Journal publishes original contributions of high scientific merit in the fields of periodontology and implant dentistry. Its scope encompasses the physiology and pathology of the periodontium, the tissue integration of dental implants, the biology and the modulation of periodontal and alveolar bone healing and regeneration, diagnosis, epidemiology, prevention and therapy of periodontal disease, the clinical aspects of tooth replacement with dental implants, and the comprehensive rehabilitation of the periodontal patient. Review articles by experts on new developments in basic and applied periodontal science and associated dental disciplines, advances in periodontal or implant techniques and procedures, and case reports which illustrate important new information are also welcome.