A 5-year cohort study on early implant placement with guided bone regeneration or alveolar ridge preservation with connective tissue graft
| Autor: | Jan Cosyn, Lorenz Seyssens, Retief Wessels, Stijn Vervaeke, Aryan Eghbali |
|---|---|
| Přispěvatelé: | Surgical clinical sciences, Oral Health |
| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Bone Regeneration medicine.medical_treatment 0206 medical engineering 02 engineering and technology Esthetics Dental Cohort Studies 03 medical and health sciences socket preservation 0302 clinical medicine Dental Implants Single-Tooth medicine Alveolar ridge Alveolar Process Animals Humans Tooth Socket Dental implant Bone regeneration General Dentistry Dental Implants Socket preservation dental implant Dentistry(all) business.industry Soft tissue 030206 dentistry Alveolar Ridge Augmentation Middle Aged 020601 biomedical engineering early implant placement Surgery Treatment Outcome guided bone regeneration single tooth Connective Tissue Cohort Cattle Female alveolar ridge preservation Implant connective tissue graft Oral Surgery business Cohort study |
| Zdroj: | Clinical implant dentistry and related researchREFERENCES. 22(6) |
| ISSN: | 1708-8208 |
| Popis: | Purpose To assess on the one hand the 5-year outcome of early implant placement with guided bone regeneration (EIP/GBR) and on the other hand of alveolar ridge preservation with late implant placement and connective tissue graft (ARP/CTG). Materials and methods Patients who had been treated with a single implant in the anterior maxilla in 2014 were selected for reevaluation in 2019. In the EIP/GBR cohort, implants were installed 4 to 8 weeks following extraction and the buccal contour was overbuilt by means of GBR. In the ARP/CTG cohort, collagen-enriched deproteinized bovine bone mineral was applied at the time of extraction and implants were installed 5 months later. All ARP/CTG cases received a buccal CTG 3 months after implant installation to reestablish buccal convexity. Primary outcomes were the pink esthetic score (PES) (Belser et al 2009) and the mucosal scarring index (MSI) (Wessels et al 2019). Clinical and radiographical parameters were secondary outcomes. Results Eighteen patients (9 females; mean age 52) in the EIP/GBR cohort, and 20 patients (9 females; mean age 38) in the ARP/CTG cohort were evaluated. PES was 6.28 following EIP/GBR. A (nearly) perfect aesthetic outcome defined as PES ≥8 was found in 3/18 cases. Perfect root convexity / soft tissue color and texture seemed most difficult to achieve. PES was 7.80 following ARP/CTG. A (nearly) perfect aesthetic outcome was found in 11/20 cases. MSI was 2.94 following EIP/GBR with 14/18 cases showing scarring. MSI yielded 0.50 following ARP/CTG with 6/20 cases showing scarring. In both cohorts, all implants survived, and none had developed periimplantitis. However, implants in the ARP/CTG cohort demonstrated a 5.4 times higher risk for periimplant mucositis than implants in the EIP/GBR cohort at 5 years follow-up. Conclusion EIP/GBR and ARP/CTG showed acceptable long-term outcomes. The aesthetic outcome was particularly favorable following ARP/CTG, yet this should be interpreted with caution due to selection bias and because soft tissue grafting was not performed in the EIP/GBR cohort. Randomized controlled trial (RCTs) comparing EIP with ARP are required to assess the need for soft tissue grafting and to evaluate clinical, aesthetic, volumetric, and patient-reported outcomes. Only on the basis of such studies clinical recommendations can be made. |
| Databáze: | OpenAIRE |
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