| Objective:To compare the results of clinical effects and radiographic data of the bone grafting on posterior-region implant with buccal small bone substitute by the guided bone regeneration(GBR)and the GBR without membrane.To investigate clinical effects of the technology without covering collagen membrane after bone grafting on posterior-region implant with buccal small bone substitute.Methods:Cases of 63 patients,33 males and 30 females,were subjected to posterior region implant surgeries at Department of Implant,Affiliated Hospital of Qingdao University from February,2017 to July,2018 were selected.The implants of the patients were not exposed,and the distances from the buccal sides to the arc of adjacent tooth alveolar ridge were more than 1 mm.The cases were randomly divided into the bone-grafting without membrane group(alloplastic bone substitute group,32 cases)and the bone-grafting with membrane covering group(GBR group,31 cases).The soft tissue and periosteum of all the patients in the bone graft replacement material group were not treated with tension-reducing treatment,and the implants were not embedded.All patients in the GBR group were operated according to the GBR standard procedure,and the implants were all embedded and healed.The horizontal bone mass variations of buccal alveolar ridge were obtained by comparing values measure in immediate post-surgeries and 6 mouths after the surgeries through the CBCT,CBCT images were processed by Dental Imaging Software,from 0,3 and 6 mm apicals to implant platforms respectively,where were set as T1,T2 and T3 respectively.The peri-implant soft tissues were evaluated by plaque index,probing pocket depths and modified bleeding index.Satisfaction degrees of the patients was obtained through OHIP-I.The evaluations on horizontal bone mass variations of alveolar ridge,peri-implant soft tissues and satisfaction degrees of the patients in the two groups were compared and analyzed.Results:(1)The final sample size was 60 cases due to the loss of follow-up of 3 patients in the later follow-up period,namely 2 cases in the bone graft replacement material group and 1 case in the GBR group.All 80 implants were achieved successful osseointegration and no implants loose or lost.The cumulative survival rate was 100%.All implants were repaired with a loading time of 3 months.No serious biological or prosthodontic complications were found in both groups.(2)According to the horizontal bone mass variations of alveolar ridge,the T1,T2 and T3 values of the alloplastic bone substitute group were(-0.48±0.73)mm,(-0.64±0.95)mm and(-0.30±0.84)mm respectively,while the T1,T2 and T3 values of the GBR groupwere(-0.35±0.66)mm、(-0.49±0.74)mm and(-0.30±0.84)mm respectively.The horizontal bone mass variations of alveolar ridge of these groups had no significantly difference(P > 0.05).(3)The PI,PD and m SBI of alloplastic bone substitute group was 1.19±0.78、(3.11±1.29)mm and 1.20±0.81.The PI,PD and m SBI of GBR group was 1.06±0.90、(3.08± 1.25)mm and 1.15 ± 0.85.The peri-implant soft tissues of these groups had no significantly difference(P > 0.05).(4)The OHIP-I of alloplastic bone substitute group was 2.12±0.45.The OHIP-I of GBR group was 2.10 ± 0.49.The satisfaction degrees of the patients of these groups had no significantly difference(P > 0.05).Conclusion:(1)Regarding posterior-region implant buccal small bone substitute,the clinical effect which is the same with GBR surgeries can be achieved simply through bone grafting,and the healthy and stable soft tissues and the high satisfaction degrees can be obtained.(2)The technology without covering collagen membrane can achieve a good and stable clinical effect for bone grafting on posterior-region implant with buccal small bone substitute and worthy of popularization and application. |
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