A randomized controlled study comparing guided bone regeneration with connective tissue graft to re‐establish convexity at the buccal aspect of single implants: A one‐year CBCT analysis

Bruyckere, Thomas De; Eeckhout, Célien; Eghbali, Aryan; Younes, Faris; Vandekerckhove, Paulien; Cleymaet, Roberto; Cosyn, Jan

doi:10.1111/jcpe.13006

Cited by 36 publications

(75 citation statements)

References 34 publications

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“…Without having cone‐beam computed tomographies (CBCTs), one can only speculate that the increase in mucosal thickness (as assessed by transmucosal probing) was accompanied by ongoing changes of the hard tissues on the buccal side of the implants, since the buccal contour slightly decreased. In a RCT comparing facial augmentation by means of SCTG or GBR, measurements were performed by superimposition of CBCTs at three different time points (before surgery, 2 weeks after surgery and at the 1‐year follow‐up) (De Bruyckere et al, 2018). The mean gain of volume (mean absolute buccal soft tissue profile gain) after one year of healing time was similar: 0.94 mm in the GBR group and 0.81 mm in the SCTG group.…”

Section: Discussionmentioning

confidence: 99%

Randomized controlled clinical trial comparing implant sites augmented with a volume‐stable collagen matrix or an autogenous connective tissue graft: 3‐year data after insertion of reconstructions

Thoma

Gasser

Jung

et al. 2020

J Clinic Periodontology

161

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Aim:To assess mid-term clinical, radiographic and profilometric outcomes at implant sites, previously grafted with a volume-stable collagen matrix (VCMX) or an autogenous subepithelial connective tissue graft (SCTG).Methods: VCMX or SCTG were randomly applied to single implant sites in 20 patients. Following abutment connection and insertion of final reconstructions (baseline), patients were re-examined at 6 months (6M), at 1 year (FU-1) and at 3 years (FU-3). Measurements included the following: clinical data, radiographic measurement of first bone to implant contact (fBIC), soft tissue thickness and volumetric outcomes. Non-parametric tests and estimates were applied for the statistical analysis. Results:The median buccal mucosal thickness increased by 0.5 mm (Q1: -0.5; Q3: 1.25) (VCMX) (p = .281) and by 0.8 mm (Q1: 0.0; Q3: 2.5) (SCTG) (p = .047) between BL and FU-3 (intergroup p = .303). The profilometric changes of the buccal soft tissues demonstrated a median decrease between BL and FU-3 of −0.2 mm (Q1: −0.5; Q3: −0.1) (p = .039) for VCMX and a decrease of −0.1 mm (Q1: −0.8; Q3: 0.1) (p = .020) for SCTG, respectively (intergroup p = .596). Peri-implant soft tissues and bone levels remained healthy throughout the entire study period. PROMs did not show any significant differences between the groups nor significant changes over time.

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Section: Discussionmentioning

confidence: 99%

Randomized controlled clinical trial comparing implant sites augmented with a volume‐stable collagen matrix or an autogenous connective tissue graft: 3‐year data after insertion of reconstructions

Thoma

Gasser

Jung

et al. 2020

J Clinic Periodontology

161

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“…RCTs demonstrated significantly less midfacial recession following the application of a connective tissue graft in the buccal mucosa following IIP (Frizzera et al., ; Yoshino, Kan, Rungcharassaeng, Roe, & Lozada, ; Zuiderveld, Meijer, den Hartog, Vissink, & Raghoebar, ). Connective tissue grafts also appear beneficial to restore buccal convexity following DIP (D'Elia et al., ; De Bruyckere, Eghbali, Younes, De Bruyn, & Cosyn, ; De Bruyckere et al., ; Eghbali, De Bruyn, Cosyn, Kerckaert, & Hoof, ; Eghbali et al., ; Hanser & Khoury, ; Stefanini et al., ). Clearly, state‐of‐the‐art implant therapy often requires soft tissue grafting following IIP as well as following DIP.…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of immediate implant placement for single tooth replacement compared to delayed implant placement: A systematic review and meta‐analysis

Cosyn

Lat

Seyssens

et al. 2019

J Clinic Periodontology

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108

111

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Aim To compare immediate implant placement (IIP) to delayed single implant placement (DIP, ≥3 months post‐extraction) in terms of implant survival (primary outcome), surgical, clinical, aesthetic, radiographic and patient‐reported outcomes (secondary outcomes). Materials and Methods Two reviewers independently performed an electronic search in PubMed, Web of Science, EMBASE and Cochrane and a hand search to identify eligible studies up to May 2018. Only randomized controlled trials (RCTs) and non‐randomized controlled studies (NRSs) comparing IIP to DIP with at least 1 year of follow‐up were selected for a qualitative analysis and meta‐analysis. Results The search identified 3 RCTs and 5 NRSs out of 2,589 titles providing data on 473 single implants (IIP: 233, DIP: 240) that had been in function between 12 and 96 months. One RCT showed unclear risk of bias, whereas all other studies demonstrated high risk. Meta‐analysis showed significantly lower implant survival for IIP (94.9%) as compared to DIP (98.9%) (RR 0.96, 95% CI [0.93; 0.99], p = 0.02). All were early implant failures. A subgroup meta‐analysis demonstrated a trend towards lower implant survival for IIP when postoperative antibiotics had not been administered (RR: 0.93, 95% CI [0.86; 1.00], p = 0.07). This was not observed among studies including the administration of postoperative antibiotics (RR: 0.98, 95% CI [0.94; 1.02], p = 0.35). Meta‐analyses showed similar probing depth (WMD 0.43 mm, 95% CI [−0.47; 1.33], p = 0.35) and aesthetic outcomes as assessed by the pink aesthetic score (standardized WMD −0.03, 95% CI [−0.46; 0.39], p = 0.88) for IIP and DIP. Data on marginal bone loss were conflicting and highly biased. Soft tissue recession was underreported and available data were highly biased. Patient‐reported outcomes were underreported, yet both IIP and DIP seemed well tolerated. Conclusion Immediate implant placement demonstrated higher risk for early implant loss than DIP. There is a need for RCTs comparing IIP to DIP with CBCT analyses at different time points and data on midfacial recession with the preoperative status as baseline. In these studies, the need for hard and soft tissue grafting should also be evaluated.

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“…This way, the factual need for soft tissue grafting can be properly assessed and surgical overtreatment can be avoided. In addition, soft tissue grafting at the time of implant placement or installation of the provisional restoration requires smaller CTGs since the occlusal aspect does not require grafting. Interestingly, applying a CTG at these time points results in excellent soft tissue aesthetics pointing to a PES of 11.17 after 5 years, which is very similar to our observations (PES 11,11).…”

Section: Discussionmentioning

confidence: 99%

A one‐year prospective study on alveolar ridge preservation using collagen‐enriched deproteinized bovine bone mineral and saddle connective tissue graft: A cone beam computed tomography analysis

Seyssens

Eghbali

Christiaens

et al. 2019

Clin Implant Dent Rel Res

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Background Although there is ample research on alveolar ridge preservation (ARP), changes of the soft tissue profile are seldom reported. In addition, the use of a saddle connective tissue graft (S‐CTG) has only been described in one study. Purpose To evaluate changes in bone and external soft tissue profile following ARP of intact and nonintact sockets using collagen‐enriched deproteinized bovine bone mineral (C‐DBBM) and a S‐CTG (a); to assess the need for additional hard and soft tissue grafting after ARP (b). Materials and Methods Patients in need of a single or multiple unit fixed reconstruction in the premaxilla were included in this prospective case series. After tooth extraction, sockets were grafted with C‐DBBM and sealed with a S‐CTG. Cone beam computed tomography slides taken before tooth extraction and 4 to 6 months after ARP were superimposed to measure changes in bone dimensions and external soft tissue profile. The need for additional hard and soft tissue grafting was registered. Implants were evaluated at 1 year. Patient‐reported outcomes were registered on a 100 mm visual analogue scale at suture removal and 1 year following ARP. Results Nineteen teeth (10 with intact sockets, 9 with nonintact sockets) in 14 patients (11 females; mean age 34) were extracted and treated with the abovementioned protocol. Volume loss could not be prevented and mainly occurred at the buccal aspect. Maximum horizontal bone resorption was 1.27 mm and maximum horizontal shrinkage of the soft tissue profile amounted to 0.87 mm, both at the most cervical aspect. Additional GBR was necessary in two sites with a nonintact buccal bone wall. The need for additional soft tissue grafting was moderate in sites with intact (3/10) and high in nonintact sockets (6/9). Implants demonstrated favorable clinical and esthetic outcomes. Pain intensity and patient satisfaction were 17 and 94, respectively. Conclusion Alveolar ridge preservation was not able to prevent relevant tissue changes. However, implants could be installed as planned. Although the application of a S‐CTG partly compensated for the buccal bone loss, the need for additional soft tissue grafting was still moderate in intact sockets and high in nonintact sockets.

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A randomized controlled study comparing guided bone regeneration with connective tissue graft to re‐establish convexity at the buccal aspect of single implants: A one‐year CBCT analysis

Abstract: Within the limitations of superimposed CBCT images, GBR and CTG are effective to re-establish convexity at the buccal aspect of single implants in the short term.

Cited by 36 publications

References 34 publications

Randomized controlled clinical trial comparing implant sites augmented with a volume‐stable collagen matrix or an autogenous connective tissue graft: 3‐year data after insertion of reconstructions

Randomized controlled clinical trial comparing implant sites augmented with a volume‐stable collagen matrix or an autogenous connective tissue graft: 3‐year data after insertion of reconstructions

The effectiveness of immediate implant placement for single tooth replacement compared to delayed implant placement: A systematic review and meta‐analysis

A one‐year prospective study on alveolar ridge preservation using collagen‐enriched deproteinized bovine bone mineral and saddle connective tissue graft: A cone beam computed tomography analysis

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