Changes in soft tissue dimensions following horizontal guided bone regeneration with a split-thickness flap design - evaluation of 8 cases with a digital method.
Kristof Somodi, Andrea Dobos, Ferenc Bartha, Eleonora Solyom, Peter Windisch, Daniel Palkovics, Balint Molnar
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Abstract
Background: Peri-implant soft tissue corrections are often indicated following alveolar ridge augmentation, due to the distortion of the keratinized mucosa at the area of augmentation. The objective of the current study was to evaluate the dimensional soft tissue changes following horizontal guided bone regeneration (GBR) utilizing 3D digital data.
Methods: 8 mandibular surgical sites with horizontal alveolar ridge deficiencies were treated utilizing a resorbable collagen membrane and a split-thickness flap design. Baseline and 6-month follow-up cone-beam computed tomography (CBCT) scans were reconstructed as 3D virtual models and were superimposed with the corresponding intraoral scan. Linear changes of supracrestal vertical- horizontal soft tissue alterations were measured in relation to the alveolar crest at the mesial- middle- and distal aspect of the surgical area. Soft tissue dimensions were measured at baseline and at 6-month follow-up.
Results: Preoperative supracrestal soft tissue height measured midcrestally averaged at 2.37 mm ± 0.68 mm, 2.37 mm ± 0.71 mm and 2.64 mm ± 0.87 mm at the mesial-, middle- and distal planes. Whereas postoperative supracrestal soft tissue height was measured at 2.62 mm ± 0.72 mm, 2.67 mm ± 0.67 mm and 3.69 mm ± 1.02 mm at the mesial, middle and distal planes, respectively. Supracrestal soft tissue width changed from 2.14 mm ± 0.72 mm to 2.47 mm ± 0.46 mm at the mesial, from 1.72 mm ± 0.44 mm to 2.07 mm ± 0.67 mm and from 2.15 mm ± 0.36 mm to 2.36 mm ± 0.59 mm at the mesial, middle and distal planes, respectively. Additionally the buccal horizontal displacement of supracrestal soft tissues could be observed.
Conclusions: The current study did not report significant supracrestal soft tissue reduction following horizontal GBR with a split-thickness flap. Even though there was a slight increase in both vertical and horizontal dimensions, differences are clinically negligible.
Trail registration: The trail was approved by the U.S. National Library of Medicine ( www.
背景：牙槽嵴增高术后，由于增高区域的角质化粘膜变形，通常需要进行种植体周围软组织修正。本研究的目的是利用三维数字数据评估水平引导骨再生（GBR）后软组织的尺寸变化。方法：利用可吸收胶原膜和分层厚度皮瓣设计治疗了 8 个下颌手术部位的水平牙槽嵴缺损。基线和 6 个月的随访锥束计算机断层扫描（CBCT）扫描结果被重建为三维虚拟模型，并与相应的口内扫描结果叠加。在手术区域的中-中-远端，测量牙槽嵴上垂直-水平软组织改变的线性变化。在基线和 6 个月随访时测量软组织尺寸：结果：术前测量的牙槽嵴顶上软组织高度平均为 2.37 mm ± 0.68 mm、2.37 mm ± 0.71 mm 和 2.64 mm ± 0.87 mm。而术后测量的嵴上软组织高度在中线、中线和远端平面分别为 2.62 mm ± 0.72 mm、2.67 mm ± 0.67 mm 和 3.69 mm ± 1.02 mm。中、中、远端平面的上颌软组织宽度分别从 2.14 mm ± 0.72 mm 变为 2.47 mm ± 0.46 mm，从 1.72 mm ± 0.44 mm 变为 2.07 mm ± 0.67 mm，从 2.15 mm ± 0.36 mm 变为 2.36 mm ± 0.59 mm。此外，还可以观察到上颌软组织的颊水平位移：结论：本研究并未发现使用劈开厚度皮瓣进行水平 GBR 后上嵴软组织明显缩小的情况。尽管垂直和水平方向的尺寸都略有增加，但临床上的差异可以忽略不计：该试验获得了美国国家医学图书馆（www.Clinicaltrials: gov）的批准；试验注册号：NCT05538715；试验时间：2011 年 12 月：NCT05538715；注册日期：2022 年 9 月 9 日。
期刊介绍：
Head & Face Medicine is a multidisciplinary open access journal that publishes basic and clinical research concerning all aspects of cranial, facial and oral conditions.
The journal covers all aspects of cranial, facial and oral diseases and their management. It has been designed as a multidisciplinary journal for clinicians and researchers involved in the diagnostic and therapeutic aspects of diseases which affect the human head and face. The journal is wide-ranging, covering the development, aetiology, epidemiology and therapy of head and face diseases to the basic science that underlies these diseases. Management of head and face diseases includes all aspects of surgical and non-surgical treatments including psychopharmacological therapies.
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