Demineralize dondurulmuş kurutulmuş kemik allogrefti kullanılan ve kullanılmayan immediat implantlarda kemik boşluğunun yönetimi: randomize kontrollü bir çalışma

Abstract

Amaç: Bu çalışma, demoralize edilmiş dondurularak kurutulmuş kemik allogrefti (DFDBA) kullanılan ve kullanılmayan anında implantlarda atlayış boşluğunun (JS) yönetimini flepsiz yaklaşım ile değerlendirmeyi ve karşılaştırmayı amaçlamaktadır. Bireyler ve Yöntem: Bu çalışmaya, üst çene ön bölgesinde anında implant yerleştirilen 40 bölge dahil edilmiştir. Grup 1 hastaları herhangi bir augmentasyon yapılmadan tedavi edilirken, Grup 2 hastalarında JS içinde DFDBA kullanılmıştır. Her iki grup, yatay boyutlarına göre JS 2 mm'den az (G1S1, G2S1) veya fazla (G1S2, G2S2) olacak şekilde alt gruplara ayrılmıştır. Plak indeksi (PI), Dişeti İndeksi (GI), Sondalama derinliği (PD), Testori estetik skoru (TS), VAS skoru, Crestal Kemik yüksekliği (CBH), Sırt genişliği (RW), Dikey mesafe (VD) ve radyolüsent alan (RA), başlangıçta ve tedaviden 12 ay sonra CBCT ile radyografik olarak değerlendirilmiştir. Bulgular: G1S1-G2S1 ve G1S2-G2S2 gruplarında orta yüz bölgesinde CBH'de sırasıyla 0.34±0.19mm ve 0.75±0.26 mm ortalamaları ile 12 ayda anlamlı farklılıklar gözlenmiştir. G1S1 ve G2S1 gruplarında TS'de ortalama 0.55±0.53 iken, G1S2 ve G2S2 gruplarında 1.33±0.82 değerleri ile anlamlı farklılıklar gözlenmiştir. Sonuç: DFDBA, orta yüz bölgesinde daha iyi CBH korunumu, RA'da azalma göstererek JS'nin daha iyi çözünmesi ve dolayısıyla daha iyi sert ve yumuşak doku iyileşmesine yol açmaktadır.

Keywords

• immediat implantlar
• kemik boşluğu
• peri-implant dokular
• kemik grefti
• doku iyileşmesi

Management of jump space in immediate implants with and without demineralised freeze dried bone allograft: a randomised controlled trial

Abstract

Purpose: The present study aimed to evaluate and compare the management of Jump space (JS) in immediate implants with and without Demineralised freeze-dried bone allograft (DFDBA) with flapless approach. Materials and Methods: The present study included 40 sites with immediate implant placement in the maxillary anterior region. Group 1 patients were treated without augmentation while Group 2 patients with DFDBA in the JS. Both the groups were further subdivided according to the horizontal dimensions as JS less (G1S1, G2S1) or more than 2mm (G1S2, G2S2). Plaque index (PI), Gingival Index (GI), Probing depth (PD), Testori esthetic score (TS), VAS score, Crestal Bone height (CBH), Ridge width (RW), Vertical distance (VD) and radiolucent area (RA) were evaluated radiographically with CBCT at baseline and 12 months’ post therapy. Results: Significant differences were observed in CBH in the midfacial region in G1S1- G2S1 with the mean of 0.34±0.19mm and G1S2 –G2S2 with 0.75±0.26 mm at 12 months. Significant differences in TS were observed in G1S1 and G2S1 with mean value of 0.55±0.53 while G1S2 and G2S2 exhibited value of 1.33±0.82. Conclusion: DFDBA shows better CBH preservation in midfacial region, reduction in RA indicating greater resolution of JS thereby leading to better hard and soft tissue healing.

Keywords

• immediate implants
• jumping gap
• peri implant tissues
• bone graft
• tissue healing

References

1. 1. Vignoletti F, Sanz M. Immediate implants at fresh extraction sockets: from myth to reality. Periodontol 2000 2014;66:132-52. google scholar
2. 2. Botticelli D, Berglundh T, Buser D, Lindhe J. The jumping distance revisited: An experimental study in the dog. Clin Oral Implants Res 2003;14:35-42. google scholar
3. 3. Sharma D, Gupta A, Jha P, Sachan S, Kumar V, Manhas K et al. Evaluation of clinical efficacy of immediate implant placement into debrided infected sockets using demineralized freeze-dried bone allograft and platelet rich fibrin membrane: A clinical trial. Int J Clin Trials 2022;9:10-7. google scholar
4. 4. Schwartz Z, Mellonig JT, Carnes DL, Fontaine JDL, Cochran DD, Boyanm BD. Ability of Commercial Demineralized Freeze-Dried Bone Allograft to Induce New Bone Formation. J Periodontol 1996;67:918-26. google scholar
5. 5. Vohra F, Al-Kheraif A, Almas K, Javed K. Comparison of crestal bone loss around dental implants placed in healed sites using flapped and flapless techniques: A systematic review. J Periodontol 2015;86:185-91. google scholar
6. 6. Fugazzotto PA. Treatment options following single-rooted tooth removal: A literatüre review and proposed hierarchy of treatment selection. J Periodontol 2005;76:821-31. google scholar
7. 7. «Paolantonio M, Dolci M, Scarano A, d'Archivio D, di Placido G, Tumini V, et al. Immediate implantation in fresh extraction sockets. A controlled clinical and histological study in man. J Periodontol 2001;72:1560-71. google scholar
8. 8. Sanz M, Lindhe J, Alcaraz J, Sanz-Sanchez I, Cecchinato D. The effect of placing a bone replacement graft in the gap at immediately placed implants: A randomized clinical trial. Clin Oral Implants Res 2017;28:902-10. google scholar

9. 9. Paknejad M, Akbari S, Aslroosta H, Panjnoush M, Hajheidary S. Effect of Flapless Immediate Implantation and Filling the Buccal Gap with Xenograft Material on the Buccal Bone Level: A Randomized Clinical Trial. J Dent Tehran Iran 2017;14:344-51. google scholar
10. 10. Silness J, Löe H. Periodontal disease in pregnancy II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand 1964;22:121-35. google scholar
11. 11. Löe, H. The gingival index, the PI and the retention index systems. J Periodontol 1967;38:38-43. google scholar
12. 12. Testori T, Bianchi F, Del Fabbro M, Capelli M, Zuffetti F, Berlucchi I, et al. Implant aesthetic score for evaluating the outcome: immediate loading in the aesthetic zone. Pract Proced Aesthet Dent 2005;17:123-30. google scholar
13. 13. Al-Sulaimani AF, Mokeem S A, Anil S. Peri-implant defect augmentation with autogenous bone: A study in beagle dogs. J Oral Implantol 2013;39:30-6. google scholar
14. 14. Neves M, Correia A, Alves CC. A novel approach to preserve the buccal wall in immediate implant cases: A clinical report. J Oral Implantol 2013;39:198-05. google scholar
15. 15. Shah KK, Kolte RA. Evaluation of Demineralized Freeze-Dried Bone Allograft in Combination with Chorion Membrane in the Treatment of Grade II Furcation Defects: A Randomized Controlled Trial. Int J Periodontics Restorative Dent 2019;39:659-67. google scholar
16. 16. Samarth G, Kolte A, Kolte R, Bajaj V. Comparative evaluation of demineralized freeze-dried bone allograft with and without concentrated growth factor membrane in the treatment of periodontal intrabony defects: a randomized controlled clinical trial. Clin Oral Investig 2023;27:1645-57. google scholar
17. 17. Bawankar PV, Kolte AP, Kolte RA. Patient-centered outcome measures comparing the autogenous and allogenic bone blocks in the augmentation of deficient alveolar ridges: A pilot study. J Indian Soc Periodontol 2023;27:87-94. google scholar
18. 18. Chen ST, Darby IB, Reynolds EC. A prospective clinical study of non-submerged immediate implants: clinical outcomes and esthetic results. Clin Oral Implants Res 2007;18:552-62. google scholar
19. 19. Araujo MG, Linder E, Lindhe J. Bio-Oss collagen in the buccal gap at immediate implants: a 6-month study in the dog. Clin Oral Implants Res 2011;22:1-8. google scholar
20. 20. Cardaropoli D, Tamagnone L, Roffredo A, Gaveglio L. Soft tissue contour changes at immediate postextraction single-tooth implants with immediate restoration: a 12-month prospective cohort study. Int J Periodontics Restorative Dent 2015;35:191-8. google scholar
21. 21. Botticelli D, Berglundh T, Lindhe J. Hard-tissue alterations following immediate implant placement in extraction sites. J Clin Periodontol 2004;31:820-8. google scholar
22. 22. Sanz M, Cecchinato D, Ferrus J, Pjetursson EB, Lang NP, Lindhe J. A prospective, randomized-controlled clinical trial to evaluate bone preservation using implants with different geometry placed into extraction sockets in the maxilla. Clin Oral implants Res 2010;21:13-21. google scholar
23. 23. Chen ST and Buser D. Esthetic outcomes following immediate and early implant placement in the anterior maxilla-a systematic review. The Int J Oral & Maxillofac implants 2014;29:186-15. google scholar
24. 24. Novaes AB Jr, Suaid F, Queiroz AC, Muglia VA, Souza SL, Palioto DB, et al. Buccal bone plate remodeling after immediate implant placement with and without synthetic bone grafting and flapless surgery: radiographic study in dogs. J Oral Implantol 2012;38:687-98. google scholar
25. 25. Abushahba F, Renvert S, Polyzois I, Claffey N. Effect of grafting materials on osseointegration of dental implants surrounded by circumferential bone defects. An experimental study in the dog. Clin Oral Implants Res 2008;19:329-34. google scholar
26. 26. Polyzois I, Renvert S, Bosshardt DD, Lang NP, Claffey N. Effect of Bio-Oss on osseointegration of dental implants surrounded by circumferential bone defects of different dimensions: an experimental study in the dog. Clin Oral Implants Res 2007;18:304-10. google scholar