PDF(Pubmed)
Abstract：
(1) Aim: a cross-linked porcine-derived collagen matrix (CMX) has been developed for soft tissue augmentation. Although this grafting material does not require a second surgical site, recent findings have indicated deeper pockets, more marginal bone loss and more midfacial recession in the short term when compared to connective tissue graft (CTG). Hence, the aim of the present study was to evaluate the safety of CMX based on buccal bone loss over a one-year period. (2) Methods: Patients who were missing a single tooth in the anterior maxilla were included, in whom the failing tooth had been removed at least 3 months prior and who presented a horizontal mucosa defect. All sites had a bucco-palatal bone dimension of at least 6 mm as assessed on Cone-Beam Computed Tomography (CBCT) to ensure complete embedding of an implant by bone. All patients received a single implant and an immediate implant restoration using a full digital workflow. Sites were randomly allocated to the control (CTG) or test group (CMX) to increase buccal soft tissue thickness. All surgeries were performed by means of full thickness mucoperiosteal flap elevation, placing CTG and CMX in contact with the buccal bone wall. Safety was assessed by evaluating the impact of CTG and CMX on buccal bone loss over a one-year period using superimposed CBCT scans. (3) Results: thirty patients were included per group (control: 50% females, mean age 50; test: 53% females, mean age 48) and 51 (control: 25; test: 26) could be analyzed for buccal bone loss. At 1 mm apical to the implant-abutment interface (IAI), most horizontal resorption was found pointing to 0.44 mm in the control group and 0.59 mm in the test group. The difference of 0.14 mm (95% CI: -0.17-0.46) was not statistically significant (p = 0.366). At 3 mm and 5 mm apical to the IAI, the difference between the groups was 0.18 mm (95% CI: -0.05-0.40; p = 0.128) and 0.02 mm (95% CI: -0.24-0.28; p = 0.899), respectively. Vertical buccal bone loss amounted to 1.12 mm in the control group and 1.14 mm in the test group. The difference of 0.02 mm (95% CI: -0.53-0.49) was not statistically significant (p = 0.926). (4) Conclusions: In the short term, soft tissue augmentation with CTG or CMX results in limited buccal bone loss. CMX is a safe alternative to CTG. Longer follow-up is needed to assess the impact of soft tissue augmentation on buccal bone.
摘要：
（1）目的：已开发出一种交联的猪衍生胶原蛋白基质（CMX），用于软组织增强。虽然这种移植材料不需要第二个手术部位，最近的发现表明口袋更深，与结缔组织移植物（CTG）相比，短期内边缘骨丢失和面部中部凹陷更多。因此，本研究的目的是基于一年内颊骨丢失评估CMX的安全性.（2）方法：包括上颌骨前部缺失单颗牙齿的患者，其中失败的牙齿至少在3个月前被移除，并且出现水平粘膜缺损。如在锥形束计算机断层扫描(CBCT)上评估的,所有部位具有至少6mm的颊腭骨尺寸,以确保植入物被骨完全嵌入。所有患者都使用完整的数字工作流程接受了单个植入物和立即的植入物修复。将部位随机分配到对照组(CTG)或试验组(CMX)以增加颊软组织厚度。所有手术均通过全厚度粘膜骨膜瓣抬高进行，放置CTG和CMX与颊骨壁接触。通过使用叠加的CBCT扫描评估CTG和CMX对一年期间颊骨丢失的影响来评估安全性。（3）结果：每组30例患者（对照组：50％女性，平均年龄50岁；测试：53%女性，平均年龄48）和51（对照：25；测试：26）可以分析颊骨丢失。在种植体-基牙界面(IAI)顶端1mm处,发现大多数水平吸收在对照组中指向0.44mm，在测试组中指向0.59mm。0.14mm(95%CI:-0.17-0.46)差异无统计学意义(p=0.366)。在IAI顶端3毫米和5毫米处，两组之间的差异为0.18mm（95％CI：-0.05-0.40;p=0.128）和0.02mm（95％CI：-0.24-0.28;p=0.899），分别。对照组垂直颊骨丢失为1.12mm，实验组为1.14mm。0.02mm(95%CI:-0.53-0.49)差异无统计学意义(p=0.926)。(4)结论:短期内,用CTG或CMX增强软组织会导致有限的颊骨丢失。CMX是CTG的安全替代品。需要更长的随访时间来评估软组织增强对颊骨的影响。
