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Clinical implant dentistry and related research最新文献

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Clinical efficacy of two vertical soft tissue augmentation techniques for peri-implant crestal bone level stability: A randomized clinical trial. 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。
Pub Date : 2024-08-11 DOI: 10.1111/cid.13365
Algirdas Puisys, Egle Vindasiute-Narbute, Dainius Razukevicius, Samuel Akhondi, German O Gallucci, Ignacio Pedrinaci

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.

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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引用次数: 0
Iliac crest vertical block grafts -placing outside or inside the bone contour: A cohort study. 髂嵴垂直块移植--置于骨轮廓外还是骨轮廓内?一项队列研究。
Pub Date : 2024-08-08 DOI: 10.1111/cid.13370
Christian Mertens, Christopher Büsch, Oliver Ristow, Jürgen Hoffmann, Hom-Lay Wang, Korbinian Jochen Hoffmann

Objective and aim: Challenging defect configurations and dimensions arise from severe, localized vertical alveolar ridge defects caused by trauma or prior surgery. This study aims to analyze three-dimensional bone gain, assess marginal bone stability in such defect configurations, and evaluate the impact of grafting outside the bone contour on the overall outcome, with a focus on iliac crest block grafts as a valid treatment option.

Materials and methods: The prospective cohort study evaluated patients who required vertical block grafting due to localized bone defects in the maxilla or mandible and who had received iliac grafts. Three-dimensional bone gain was analyzed using cone beam computed tomography (CBCT) after 3 months of bone healing for each treated site and implant position. A comparison between bone grafts inside and outside the bone contour was conducted. Marginal bone stability was measured using intraoral radiographs during routine annual follow-up visits.

Results: Seventy patients with 89 treated sites were evaluated. After 3 months of graft healing, the mean vertical bone gain was 11.03 ± 3.54 mm, the mean horizontal bone gain was 7.18 ± 2.00 mm, and the mean graft length was 28.19 ± 11.01 mm. A total of 217 implants were placed in the augmented regions. On implant level, a mean vertical bone gain of 10.44 ± 3.44 mm and a mean horizontal bone gain of 6.54 ± 1.86 mm were measured. Over a 43-month observation period, mesial and distal marginal bone loss averaged 0.44 ± 0.92 mm and 0.49 ± 1.05 mm, respectively. Eight implants were diagnosed with periimplantitis, resulting in the loss of four implants, while no early implant losses were reported.

Conclusion: Within the limitations of this study, vertical bone grafts with iliac crest block grafts were found to be a dependable treatment option for dental implant placement, and placing block grafts outside the bone contour did not lead to inferior outcomes.

目的和宗旨:由于外伤或之前的手术造成的严重、局部垂直牙槽嵴缺损,其缺损结构和尺寸具有挑战性。本研究旨在分析三维骨增量,评估此类缺损构型的边缘骨稳定性,并评估骨轮廓外移植对整体效果的影响,重点是将髂嵴块状移植作为一种有效的治疗方案:这项前瞻性队列研究评估了因上颌骨或下颌骨局部骨缺损而需要进行垂直块状移植,并接受过髂骨移植的患者。在每个治疗部位和种植体位置的骨愈合 3 个月后,使用锥形束计算机断层扫描(CBCT)分析了三维骨增量。对骨轮廓内外的植骨进行了比较。在每年的例行随访中,使用口内X光片测量边缘骨的稳定性:对 70 名患者的 89 个治疗部位进行了评估。移植骨愈合 3 个月后,垂直骨增量平均为 11.03 ± 3.54 毫米,水平骨增量平均为 7.18 ± 2.00 毫米,移植骨长度平均为 28.19 ± 11.01 毫米。在增量区域共植入了 217 个种植体。在种植体水平上,垂直骨增量平均为(10.44 ± 3.44)毫米,水平骨增量平均为(6.54 ± 1.86)毫米。在 43 个月的观察期内,中轴和远轴边缘骨量损失平均分别为 0.44 ± 0.92 毫米和 0.49 ± 1.05 毫米。8颗种植体被诊断为种植体周围炎,导致4颗种植体脱落,但没有早期种植体脱落的报告:结论:在本研究的局限性范围内,发现垂直骨移植与髂嵴块移植是种植牙的可靠治疗方案,在骨轮廓外放置块移植不会导致较差的结果。
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引用次数: 0
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Clinical implant dentistry and related research
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