Le, Bach T., Borzabadi-Farahani, Ali and Nielsen, Brady (2016) Treatment of labial soft tissue recession around dental implants in the esthetic zone using guided bone regeneration with mineralized allograft : a retrospective clinical case series. Journal of Oral and Maxillofacial Surgery, 74 (8). pp. 1552-1561. doi:10.1016/j.joms.2016.04.015

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Abstract

Objectives:
Soft tissue augmentation procedures are often performed to correct gingival recesson on the facial aspects of implants in the esthetic zone. This retrospective clinical case series reports on the use of guided bone regeneration (GBR) and coronal advancement flap with resorbable membrane and allograft.

Materials and methods:
Records of 14 patients (7 male, 7 female) with a mean (SD) age of 36.78 (13.9) years who were treated for soft tissue recessions around implant-supported restorations in the maxillary central or lateral incisor location were analysed. Implant diameters ranged from 3.3-4.7 mm. All patients had bone loss confined to the labial surface of the implant. A solvent-dehydrated particulate mineralized allograft (Puros Cancellous Bone Allograft, Zimmer Biomet Dental, Palm Beach Gardens, FL) and a resorbable membrane (CopiOs Pericardium, Zimmer Biomet Dental) were used in a GBR surgical procedure in combination with a roughened titanium tenting screw placed 3-4 mm below the implant platform to restore unesthetic defects in the anterior maxilla.

Results:
All postoperative tissue changes from their preoperative states were statistically significant (p < 0.05, Wilcoxon Signed-Rank test). Mean [SD, 95% Confidence Interval (CI)] preoperative crestal bone thickness (measured 2 mm from crest and mid-implant buccal bone thickness) increased by 1.84 (0.89, 1.32-2.35) mm and 2.07 (0.81, 1.60-2.53) mm, respectively, approximately one year after treatment (p <0.001). Significant mean (SD, 95% CI) increases of 1.28 (0.53, 0.97-1.58) mm, 1.29 (0.81, 0.82-1.75) mm and 1.23 (0.53, 0.92-1.53) mm were also noted in soft tissue thickness, keratinized tissue width, and gingival height, respectively (p <0.001).

Conclusion:
Use of the allograft and xenogenic membrane effectively increased alveolar hard and soft tissue dimensions in the esthetic zone of the anterior maxilla. Future prospective clinical trials with a control group are needed to compare this technique with conventional methods such as connective tissue graft.

Item Type:	Journal Article
Subjects:	R Medicine > RK Dentistry
Divisions:	Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Dental implants, Gums -- Diseases
Journal or Publication Title:	Journal of Oral and Maxillofacial Surgery
Publisher:	W.B. Saunders Co.
ISSN:	0278-2391
Official Date:	August 2016
Dates:	Date Event August 2016 Published 25 April 2016 Available 16 April 2016 Accepted 12 February 2016 Submitted
Date of first compliant deposit:	29 April 2016
Volume:	74
Number:	8
Page Range:	pp. 1552-1561
DOI:	10.1016/j.joms.2016.04.015
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
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