PDF(Pubmed)
Abstract：
OBJECTIVE: This retrospective cohort study evaluates the influence of connective tissue grafts (CTG) on bone regeneration at implant sites with total loss of the buccal bone wall treated with flapless immediate implant placement (IIP) and reconstruction with autogenous bone chips (AB) within a follow-up of up to 13 years.
METHODS: Sixty implants were inserted in 55 patients in sites with total loss of the buccal bone wall between 2008 and 2021. The implants were inserted and the buccal gaps were grafted by AB. A subgroup of 34 sites was grafted additionally with CTG using tunnel technique. Primary outcome was the vertical bone regeneration in height and thickness. Secondary outcome parameters were interproximal marginal bone level, recession, soft tissue esthetics (PES), width of keratinized mucosa (KMW) and probing depths (PPD).
RESULTS: Mean follow-up period was 60.8 months. In 55 sites a complete vertical bone regeneration was documented. The mean buccal bone level increased by 10.6 mm significantly. The thickness of the buccal bone wall ranged between 1.7 and 1.9 mm, and was significantly thicker in sites without CTG. Interproximal marginal bone level was at implant shoulder level. The mean recession improved significantly by 1.2 mm. In sites with CTG, recessions and PES improved significantly more.
CONCLUSIONS: Additional CTG in extraction sites with total buccal bone loss followed by IIP with simultaneous AB grafting led to improved PES and recession, but also to a thinner buccal bone wall compared to sites grafted just with AB.
METHODS: Sixty implants were inserted in 55 patients in sites with total loss of the buccal bone wall between 2008 and 2021. The implants were inserted and the buccal gaps were grafted by AB. A subgroup of 34 sites was grafted additionally with CTG using tunnel technique. Primary outcome was the vertical bone regeneration in height and thickness. Secondary outcome parameters were interproximal marginal bone level, recession, soft tissue esthetics (PES), width of keratinized mucosa (KMW) and probing depths (PPD).
RESULTS: Mean follow-up period was 60.8 months. In 55 sites a complete vertical bone regeneration was documented. The mean buccal bone level increased by 10.6 mm significantly. The thickness of the buccal bone wall ranged between 1.7 and 1.9 mm, and was significantly thicker in sites without CTG. Interproximal marginal bone level was at implant shoulder level. The mean recession improved significantly by 1.2 mm. In sites with CTG, recessions and PES improved significantly more.
CONCLUSIONS: Additional CTG in extraction sites with total buccal bone loss followed by IIP with simultaneous AB grafting led to improved PES and recession, but also to a thinner buccal bone wall compared to sites grafted just with AB.
摘要：
目的：这项回顾性队列研究评估了结缔组织移植物（CTG）对植入部位骨再生的影响，在长达13年的随访时间内，通过无瓣立即植入（IIP）和自体骨片（AB）重建治疗颊骨壁完全丢失。
方法：在2008年至2021年之间，在55例患者的颊骨壁完全丧失的部位插入了60个植入物。插入植入物，并通过AB移植颊间隙。使用隧道技术将34个位点的亚组另外与CTG接枝。主要结果是高度和厚度的垂直骨再生。次要结果参数为邻间边缘骨水平，经济衰退,软组织美学（PES），角化粘膜宽度（KMW）和探测深度（PPD）。
结果：平均随访期为60.8个月。在55个部位记录了完整的垂直骨再生。平均颊骨水平显着增加了10.6mm。颊骨壁的厚度范围在1.7至1.9mm之间，并且在没有CTG的部位明显更厚。邻间边缘骨水平在植入物肩部水平。平均衰退显著改善1.2毫米。在有CTG的地方，经济衰退和PES明显改善。
结论：在全颊骨丢失的拔牙部位增加CTG，随后在同时进行AB移植的IIP导致PES改善和衰退，而且与仅用AB移植的部位相比，颊骨壁更薄。
方法：在2008年至2021年之间，在55例患者的颊骨壁完全丧失的部位插入了60个植入物。插入植入物，并通过AB移植颊间隙。使用隧道技术将34个位点的亚组另外与CTG接枝。主要结果是高度和厚度的垂直骨再生。次要结果参数为邻间边缘骨水平，经济衰退,软组织美学（PES），角化粘膜宽度（KMW）和探测深度（PPD）。
结果：平均随访期为60.8个月。在55个部位记录了完整的垂直骨再生。平均颊骨水平显着增加了10.6mm。颊骨壁的厚度范围在1.7至1.9mm之间，并且在没有CTG的部位明显更厚。邻间边缘骨水平在植入物肩部水平。平均衰退显著改善1.2毫米。在有CTG的地方，经济衰退和PES明显改善。
结论：在全颊骨丢失的拔牙部位增加CTG，随后在同时进行AB移植的IIP导致PES改善和衰退，而且与仅用AB移植的部位相比，颊骨壁更薄。
