Naenni, Nadja
(Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich)
,
Berner, Tanja
(Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich)
,
Waller, Tobias
(Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich)
,
Huesler, Juerg
(Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich)
,
Hammerle, Christoph Hans Franz
(Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich)
,
Thoma, Daniel Stefan
(Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich)
Purpose: To assess the influence of using different combinations of guided bone regeneration (GBR) materials on volume changes after wound closure at peri-implant dehiscence defects. Methods: In 5 pig mandibles, standardized bone defects were created and implants were centrally placed. The defects w...
Purpose: To assess the influence of using different combinations of guided bone regeneration (GBR) materials on volume changes after wound closure at peri-implant dehiscence defects. Methods: In 5 pig mandibles, standardized bone defects were created and implants were centrally placed. The defects were augmented using different combinations of GBR materials: xenogeneic granulate and collagen membrane (group 1, n=10), xenogeneic granulate and alloplastic membrane (group 2, n=10), alloplastic granulates and alloplastic membrane (group 3, n=10). The horizontal thickness was assessed using cone-beam computed tomography before and after suturing. Measurements were performed at the implant shoulder (HT0) and at 1 mm (HT1) and 2mm (HT2) below. The data were statistically analysed using the Wilcoxon signed-rank test to evaluate within-group differences. Bonferroni correction was applied when calculating statistical significance between the groups. Results: The mean horizontal thickness before suturing was $2.55{\pm}0.53mm$ (group 1), $1.94{\pm}0.56mm$ (group 2), and $2.49{\pm}0.73mm$ (group 3). Post-suturing, the values were $1.47{\pm}0.31mm$ (group 1), $1.77{\pm}0.27mm$ (group 2), and $2.00{\pm}0.48mm$ (group 3). All groups demonstrated a loss of horizontal dimension. Intragroup changes exhibited significant differences in group 1 (P<0.001) and group 3 (P<0.01). Intergroup comparisons revealed statistically significant differences of the relative changes between groups 1 and 2 (P=0.033) and groups 1 and 3 (P=0.015). Conclusions: Volume change after wound closure was minimized by using an alloplastic membrane. The stability of the augmented horizontal thickness was most ensured by using this type of membrane irrespective of the bone substitute material used for membrane support.
Purpose: To assess the influence of using different combinations of guided bone regeneration (GBR) materials on volume changes after wound closure at peri-implant dehiscence defects. Methods: In 5 pig mandibles, standardized bone defects were created and implants were centrally placed. The defects were augmented using different combinations of GBR materials: xenogeneic granulate and collagen membrane (group 1, n=10), xenogeneic granulate and alloplastic membrane (group 2, n=10), alloplastic granulates and alloplastic membrane (group 3, n=10). The horizontal thickness was assessed using cone-beam computed tomography before and after suturing. Measurements were performed at the implant shoulder (HT0) and at 1 mm (HT1) and 2mm (HT2) below. The data were statistically analysed using the Wilcoxon signed-rank test to evaluate within-group differences. Bonferroni correction was applied when calculating statistical significance between the groups. Results: The mean horizontal thickness before suturing was $2.55{\pm}0.53mm$ (group 1), $1.94{\pm}0.56mm$ (group 2), and $2.49{\pm}0.73mm$ (group 3). Post-suturing, the values were $1.47{\pm}0.31mm$ (group 1), $1.77{\pm}0.27mm$ (group 2), and $2.00{\pm}0.48mm$ (group 3). All groups demonstrated a loss of horizontal dimension. Intragroup changes exhibited significant differences in group 1 (P<0.001) and group 3 (P<0.01). Intergroup comparisons revealed statistically significant differences of the relative changes between groups 1 and 2 (P=0.033) and groups 1 and 3 (P=0.015). Conclusions: Volume change after wound closure was minimized by using an alloplastic membrane. The stability of the augmented horizontal thickness was most ensured by using this type of membrane irrespective of the bone substitute material used for membrane support.
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제안 방법
To analyse the horizontal thickness, CBCT sections of the area perpendicular to the implant axis were enlarged using open-source image processing software (imageJ, National Institutes of Health, Bethesda, MD, USA). A transparent acetate foil displaying a printed implant and the respective levels for the implant shoulder (HT0), as well as 1 mm (HT1) and 2 mm (HT2) below the implant shoulder, was placed on each image on the computer display to facilitate the reproducibility of the measurements. The horizontal thickness of the augmented material was then measured at HT0, HT1, and HT2 on the cross-sectional images obtained from the CBCT scans (Figure 4).
Mixed linear models were used for the comparison of the 3 groups due to the correlated data. Separate measurements were made for baseline values and post-treatment values, from which the changes were calculated. Post hoc tests were used for paired comparisons, applying the Bonferroni correction.
Mean values and standard deviations are given in (mm), as are values for the first quartile (Q1), median, and third quartile (Q3). The P values were obtained from analysis of variance of the post hoc between-group comparisons adjusted for multiple testing.
The aim of the present study was to radiographically assess the influence of wound closure after the application of 2 bone substitute materials (xenogeneic and alloplastic) and 2 membranes (xenogeneic and alloplastic) for GBR at peri-implant bone defects.
One created the bone defects, placed the implants, and performed GBR. The second researcher performed the wound closure in order to eliminate operator bias.
The volume of the augmented area was examined before and after suturing using CBCT (I-Dixel, J. Morita MFG.CORP., Kyoto Japan), applying the following technical parameters: acceleration voltage, 90 kV; beam current, 5 mA; field of view (FOV), 10 cm×4 cm; rotation, 360°; voxel size, 0.250 mm; scan time, 17.5 seconds.
대상 데이터
The experiment was performed by 2 surgeons. One created the bone defects, placed the implants, and performed GBR.
이론/모형
Separate measurements were made for baseline values and post-treatment values, from which the changes were calculated. Post hoc tests were used for paired comparisons, applying the Bonferroni correction. The significance level was set at 5%.
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