PDF(Pubmed)
Abstract：
BACKGROUND: Emerging clinical data points to the relevance of the presence of keratinized tissue (KT). Although apically positioned flap/vestibuloplasty along with free gingival graft (FGG) is considered as a standard intervention for augmenting KT, substitute materials appear to be a viable treatment alternative. So far, there is a lack of data investigating the dimensional changes at implant sites treated with soft-tissue substitutes or FGG.
OBJECTIVE: The present study aimed at comparing three-dimensional changes of a porcine derived collagen matrix (CM) and FGG for increasing KT at dental implants over a 6-month follow-up period.
METHODS: The study enrolled 32 patients exhibiting deficient KT width (i.e., < 2 mm) at the vestibular aspect who underwent soft tissue augmentation using either CM (15 patients/23 implants) or FGG (17 patients/31 implants). The primary outcome was defined as tissue thickness change (mm) at treated implant sites between 1- (S0), 3- (S1), and 6-months (S2). Secondary outcomes considered changes of KT width over a 6-month follow-up period, surgical treatment time, and patient-reported outcomes.
RESULTS: Dimensional analyses from S0 to S1 and from S0 to S2 revealed a mean decrease in tissue thickness of - 0.14 ± 0.27 mm and - 0.04 ± 0.40 mm in the CM group, and - 0.08 ± 0.29 mm and - 0.13 ± 0.23 mm in the FGG group, with no significant differences noted between the groups (3 months: p = 0.542, 6 months: p = 0.659). Likewise, a comparable tissue thickness decrease was observed from S1 to S2 in both groups (CM: - 0.03 ± 0.22 mm, FGG: - 0.06 ± 0.14 mm; p = 0.467). The FGG group exhibited a significantly greater KT gain after 1, 3 and 6 months compared to the CM group (1 month: CM: 3.66 ± 1.67 mm, FGG: 5.90 ± 1.58 mm; p = 0.002; 3 months: CM: 2.22 ± 1.44; FGG: 4.91 ± 1.55; p = 0.0457; 6 months: CM: 1.45 ± 1.13 mm, FGG: 4.52 ± 1.40 mm; p < 0.1). Surgery time (CM: 23.33 ± 7.04 min.; FGG: 39.25 ± 10.64 min.; p = 0.001) and postoperative intake of analgesics were significantly lower in the CM group (CM: 1.2 ± 1.08 tablets; FGG: 5.64 ± 6.39 tablets; p = 0.001).
CONCLUSIONS: CM and FGG were associated with comparable three-dimensional thickness changes between 1 and 6 months. While a wider KT band could be established with FGG, the use of CM significantly reduced surgical time and patients´ intake of analgesics.
OBJECTIVE: The present study aimed at comparing three-dimensional changes of a porcine derived collagen matrix (CM) and FGG for increasing KT at dental implants over a 6-month follow-up period.
METHODS: The study enrolled 32 patients exhibiting deficient KT width (i.e., < 2 mm) at the vestibular aspect who underwent soft tissue augmentation using either CM (15 patients/23 implants) or FGG (17 patients/31 implants). The primary outcome was defined as tissue thickness change (mm) at treated implant sites between 1- (S0), 3- (S1), and 6-months (S2). Secondary outcomes considered changes of KT width over a 6-month follow-up period, surgical treatment time, and patient-reported outcomes.
RESULTS: Dimensional analyses from S0 to S1 and from S0 to S2 revealed a mean decrease in tissue thickness of - 0.14 ± 0.27 mm and - 0.04 ± 0.40 mm in the CM group, and - 0.08 ± 0.29 mm and - 0.13 ± 0.23 mm in the FGG group, with no significant differences noted between the groups (3 months: p = 0.542, 6 months: p = 0.659). Likewise, a comparable tissue thickness decrease was observed from S1 to S2 in both groups (CM: - 0.03 ± 0.22 mm, FGG: - 0.06 ± 0.14 mm; p = 0.467). The FGG group exhibited a significantly greater KT gain after 1, 3 and 6 months compared to the CM group (1 month: CM: 3.66 ± 1.67 mm, FGG: 5.90 ± 1.58 mm; p = 0.002; 3 months: CM: 2.22 ± 1.44; FGG: 4.91 ± 1.55; p = 0.0457; 6 months: CM: 1.45 ± 1.13 mm, FGG: 4.52 ± 1.40 mm; p < 0.1). Surgery time (CM: 23.33 ± 7.04 min.; FGG: 39.25 ± 10.64 min.; p = 0.001) and postoperative intake of analgesics were significantly lower in the CM group (CM: 1.2 ± 1.08 tablets; FGG: 5.64 ± 6.39 tablets; p = 0.001).
CONCLUSIONS: CM and FGG were associated with comparable three-dimensional thickness changes between 1 and 6 months. While a wider KT band could be established with FGG, the use of CM significantly reduced surgical time and patients´ intake of analgesics.
摘要：
背景：新兴的临床数据指出了角质化组织（KT）的存在的相关性。尽管顶部定位的皮瓣/前庭成形术以及游离牙龈移植物（FGG）被认为是增加KT的标准干预措施，替代材料似乎是一种可行的治疗方法。到目前为止,缺乏调查用软组织替代物或FGG治疗的植入部位尺寸变化的数据.
目的：本研究旨在比较猪来源的胶原基质（CM）和FGG在6个月随访期间增加牙种植体KT的三维变化。
方法：该研究招募了32名表现出KT宽度不足的患者（即<2mm）在前庭方面使用CM（15名患者/23个植入物）或FGG（17名患者/31个植入物）进行软组织增强。主要结果定义为1-（S0）之间治疗植入部位的组织厚度变化（mm），3-(S1),6个月（S2）。次要结果考虑了6个月随访期间KT宽度的变化，手术治疗时间,和患者报告的结果。
结果：从S0到S1和从S0到S2的尺寸分析显示，CM组的组织厚度平均减少-0.14±0.27mm和-0.04±0.40mm，FGG组的-0.08±0.29mm和-0.13±0.23mm，两组之间没有显着差异（3个月：p=0.542，6个月：p=0.659）。同样，在两组中，从S1到S2观察到相当的组织厚度下降（CM：-0.03±0.22mm，FGG:-0.06±0.14mm;p=0.467)。与CM组相比，FGG组在1、3和6个月后表现出明显更大的KT增益（1个月：CM：3.66±1.67mm，FGG:5.90±1.58mm;p=0.002;3个月:CM:2.22±1.44;FGG:4.91±1.55;p=0.0457;6个月:CM:1.45±1.13mm,FGG:4.52±1.40mm;p<0.1)。手术时间（CM：23.33±7.04分钟。；FGG：39.25±10.64分钟。；p=0.001），CM组术后镇痛药的摄入量显着降低（CM：1.2±1.08片；FGG：5.64±6.39片；p=0.001）。
结论：CM和FGG在1至6个月之间具有相当的三维厚度变化。虽然可以使用FGG建立更宽的KT频段，CM的使用显着减少了手术时间和患者的镇痛药摄入量。
目的：本研究旨在比较猪来源的胶原基质（CM）和FGG在6个月随访期间增加牙种植体KT的三维变化。
方法：该研究招募了32名表现出KT宽度不足的患者（即<2mm）在前庭方面使用CM（15名患者/23个植入物）或FGG（17名患者/31个植入物）进行软组织增强。主要结果定义为1-（S0）之间治疗植入部位的组织厚度变化（mm），3-(S1),6个月（S2）。次要结果考虑了6个月随访期间KT宽度的变化，手术治疗时间,和患者报告的结果。
结果：从S0到S1和从S0到S2的尺寸分析显示，CM组的组织厚度平均减少-0.14±0.27mm和-0.04±0.40mm，FGG组的-0.08±0.29mm和-0.13±0.23mm，两组之间没有显着差异（3个月：p=0.542，6个月：p=0.659）。同样，在两组中，从S1到S2观察到相当的组织厚度下降（CM：-0.03±0.22mm，FGG:-0.06±0.14mm;p=0.467)。与CM组相比，FGG组在1、3和6个月后表现出明显更大的KT增益（1个月：CM：3.66±1.67mm，FGG:5.90±1.58mm;p=0.002;3个月:CM:2.22±1.44;FGG:4.91±1.55;p=0.0457;6个月:CM:1.45±1.13mm,FGG:4.52±1.40mm;p<0.1)。手术时间（CM：23.33±7.04分钟。；FGG：39.25±10.64分钟。；p=0.001），CM组术后镇痛药的摄入量显着降低（CM：1.2±1.08片；FGG：5.64±6.39片；p=0.001）。
结论：CM和FGG在1至6个月之间具有相当的三维厚度变化。虽然可以使用FGG建立更宽的KT频段，CM的使用显着减少了手术时间和患者的镇痛药摄入量。
