腭侧结缔组织瓣与脱细胞真皮基质移植扩增种植体唇侧组织的效果比较

目的:比较腭黏膜下结缔组织瓣和异体脱细胞真皮基质(ADM)移植丰满种植区唇侧软组织的效果。方法:22例上前牙区单牙缺失患者,伴缺牙区唇侧牙槽外形凹陷。其中12例行牙种植术同期腭黏膜下结缔组织瓣移植术,10例行牙种植术同期种植区唇侧骨膜下ADM膜覆盖。分别于种植术前,术后2周、3个月、6个月、12个月通过石膏模型分析2组种植区牙槽嵴水平宽度的变化。采用SAS6.12软件包对2组实验数据进行t检验,以确定不同时期2组结果是否有显著性差异。结果:随访期内,2组种植体存留率为100%,种植术后2周及术后3、6、12个月腭黏膜下结缔组织瓣移植组及ADM移植组的牙槽嵴宽度较种植术前均有显著差异(P<0.05);术后各时间段2组牙槽嵴水平宽度扩增量无显著性差异(P>0.05)。结论:腭侧黏膜下结缔组织瓣移植、ADM膜骨膜下移植均能明显改善种植区唇侧丰满度,且扩增水平相近。

Comparison of acellular dermal matrix graft and palatal connective tissue graft in the augmentation of labial tissue around implants

PURPOSE: To compare the effect of palatal connective tissue graft and acellular dermal matrix (ADM) transplantation to improve the labial contour of implants. METHODS: 22 patients with single missing tooth and buccal soft tissue defects in the anterior maxilla underwent dental implant therapy. Simultaneously, 12 patients received palatal connective tissue transplantation, while 10 patients received ADM graft and all sites were studied for 12 months. The horizontal width of the alveolar crest were evaluated before surgery and 2 weeks, 3, 6, 12 months after surgery through cast study,statistical evaluation was completed with Student's t test using SAS6.12 software package to determine whether significant differences existed at the 95% significance level. RESULTS: The survival rate for both groups during the 12- month follow-up was 100%. The horizontal widths of alveolar crest of both groups at the follow-up 2 weeks and 3, 6, 12 months were significantly higher than the preoperative values (P<0.05). There was no significant difference between the groups in horizontal width increase of alveolar crest at all time points postoperatively. CONCLUSIONS: Palatal submucosal connective tissue graft and acellular dermal matrix subperiosteal transplantation can equally correct the buccal soft tissue defects around the dental implants.