Analysis of clinical aesthetic effect of buccal alveolar ridge preservation and connective tissue transplantation with single implant

doi:10.19439/j.sjos.2020.06.011

Abstract

Abstract: PURPOSE: To evaluate the clinical aesthetic effect of buccal alveolar ridge preservation (ARP) and connective tissue transplantation (CTG) in patients who received a single implant. METHODS: Forty-three patients with tooth loss admitted to the Department of Stomatology of Shunde Hospital of Southern Medical University from May 2014 to May 2016 were included in the study. Tooth extraction, ARP, implant implantation, CTG and permanent repair were performed respectively. The incidence of bleeding, depth of probing, marginal bone resorption, and red-white aesthetic effect of implants were evaluated 1 year and 3 years after surgery. The buccal mucosa thickness of implants before, immediately after CTG, 1 year and 3 years after surgery were measured. The patient satisfaction was evaluated by visual analogue scale (VAS) from masticatory function, overall aesthetics, attachment height, and color, respectively. The implant conditions at the third year after surgery were observed, and complications during follow-up were recorded. SPSS 20.0 software package was used for statistical analysis of the data. RESULTS: The follow-up rate in the first year after surgery was 100%, and that in the third year after surgery was 90.70%. One year and 3 years after operation, the aesthetic effect of the implant was satisfactory. At the 3rd year after operation, the scores of the near middle gingival papillary were significantly higher than that at the 1st year after operation (P<0.05). The buccal mucosal thickness of the implant immediately after CTG and 1 year and 3 years after surgery increased significantly compared with that before CTG (P<0.05). The buccal mucosal thickness of the implant increased 1.02 mm (relative stability: 90.12%) 1 year after operation and 1.01 mm (relative stability: 84.31%) 3 years after operation, respectively. The satisfaction scores of the patients on chewing function, overall aesthetics, attachment height and color of the implant immediately after CTG, one year after surgery and 3 years after surgery were all > 8. The 3-year survival rate of the implants was 100%, and the 3-year success rate of the implants was 97.44%. During the follow-up, two patients developed peri-implant mucositis, which was relieved after tooth cleaning, but no complications such as tissue flap necrosis, limited opening and tongue movement disorder occurred. CONCLUSIONS: ARP and CTG have good clinical and aesthetic effects on patients with tooth loss. In three years, the buccal mucosal thickness of the implant can be increased and relatively stable, which is worthy of clinical promotion and application.

Key words: Alveolar ridge preservation, Connective tissue graft, Clinical effect, Aesthetic effect

CLC Number:

R782.2

WU Shi-qing, LU Hai-bin, WEN Zhi-xin, ZHANG Xue-yang, CHEN Guo-dong. Analysis of clinical aesthetic effect of buccal alveolar ridge preservation and connective tissue transplantation with single implant[J]. Shanghai Journal of Stomatology, 2020, 29(6): 617-622.

References

[1] Jayasinghe RM, Perera J, Jayasinghe V, et al.Awareness, attitudes, need and demand on replacement of missing teeth among a group of partially dentate patients attending a University Dental Hospital[J]. BMC Res Notes, 2017, 10(1): 334-334.
[2] 梁向新, 余晓波, 黄媖. 拔牙位点保存技术对口腔种植患者牙槽美学效果的影响[J]. 广东医学, 2017, 38(23): 3628-3630.
[3] 宫苹. 牙缺失种植修复并发症与咬合[J]. 中华口腔医学杂志, 2018, 53(12): 800-804.
[4] Jung RE, Ioannidis A, Hämmerle CHF, et al.Alveolar ridge preservation in the esthetic zone[J]. Periodontol 2000, 2018, 77(1): 165-175.
[5] Troiano G, Zhurakivska K, Muzio LL, et al.Combination of bone graft and resorbable membrane for alveolar ridge preservation: a systematic review and meta-analysis[J]. J Periodontol, 2018, 89(1): 46-57.
[6] Tonetti MS, Cortellini P, Pellegrini G, et al.Xenogenic collagen matrix or autologous connective tissue graft as adjunct to coronally advanced flaps for coverage of multiple adjacent gingival recession: randomized trial assessing non-inferiority in root coverage and superiority in oral health-related[J]. J Clin Periodontol, 2018, 45(1): 78-88.
[7] Sabet JM, Amoian B, Seyedmajidi M.Histological and histomorphometric evaluation of the synthetic biomaterial Natix in horizontal reconstruction of alveolar ridge[J]. Dent Res J(Isfahan), 2017, 14(2): 97-103.
[8] Tu V, Kumar S.Limited evidence suggests that alveolar ridge preservation is more favorable than unassisted socket healing in minimizing alveolar ridge dimensional changes after extraction[J]. J Evid Based Dent Pract, 2018, 18(1): 85-87.
[9] 蒋瑷, 张强, 罗纬, 等. 上颌单颗前牙位点保存后邻面牙槽嵴高度的早期变化[J]. 华西口腔医学杂志, 2019, 37(4): 394-397.
[10] Menchini Fabris GB, Marconcini S, Barone A, et al.Buccal bone dimensions and aesthetic outcome at maxillary incisors replaced by conventional dental implants. A case series with a 5-year follow-up[J]. J Biol Regul Homeost Agents, 2017, 31(2 Suppl): 15-22.
[11] 曾小法, 陈宁, 尹颖. 上颌中切牙微创拔牙即刻种植联合牙龈诱导的美学效果[J]. 口腔医学研究, 2017, 33(12): 1323-1327.
[12] 姚本栈, 黄慧, 凌厉. 腭侧结缔组织瓣唇向卷入技术应用于种植前牙软组织增量的临床研究[J]. 中国医师杂志, 2017, 19(10): 1517-1519.
[13] 谢艳婷, 江鹭鹭, 何晶, 等. 美学区单颗牙即刻种植和延期种植的短期红色美学和种植体边缘骨吸收的临床效果比较及影响因素分析[J].上海口腔医学, 2019, 28(2): 148-153.
[14] 陈信中, 刘亦涵, 陈建钢, 等. 2种不同材质临时基台的前牙区即刻种植修复临床效果[J]. 临床口腔医学杂志, 2019, 35(3): 163-165.
[15] Mailoa J, Arnett M, Chan HL, et al.The association between buccal mucosa thickness and periimplant bone loss and attachment loss: a cross-sectional study[J]. Implant Dent, 2018, 27(5): 575-581.