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Soft tissue augmentation of ridge defects in the maxillary anterior area using two different methods: a randomized controlled clinical trial


Akcalı, A; Schneider, D; Unlü, F; Bıcakcı, N; Köse, T; Hämmerle, C H F (2015). Soft tissue augmentation of ridge defects in the maxillary anterior area using two different methods: a randomized controlled clinical trial. Clinical Oral Implants Research, 26(6):688-695.

Abstract

OBJECTIVES: To test whether or not vascularized interpositional periosteal-connective tissue grafts are as successful as free subepithelial connective tissue grafts in augmenting volume defects in the anterior maxilla.
MATERIAL AND METHODS: Twenty subjects with Seibert class 1 ridge defects in the anterior maxilla were randomly, equally assigned to augmentation by vascularized interpositional periosteal-connective tissue graft (test) or free subepithelial connective tissue graft (control). Clinical periodontal parameters at teeth adjacent to the gap were recorded, and conventional impressions were taken prior to surgery (baseline = t0 ) and 1 (t1 ), 3 (t3 ) and 6 (t6 ) months after surgery. The casts were optically scanned, digitized and analyzed for ridge contour changes in the augmented area. Data were subjected to nonparametric statistics.
RESULTS: The contour changes in labial distance between baseline and follow-up for the control group were (median, range) 1 mm, 0.37-1.45 (t0 -t1 ); 1.18 mm, 0.39-1.40 (t0 -t3 ); and 0.63 mm, 0.28-1.22 (t0 -t6 ) and for test group 1.21 mm, 0.74-2.47 (t0 -t1 ); 1.26 mm, 0.50-1.71 (t0 -t3 ); and 1.18 mm, 0.16-1.75 (t0 -t6 ). Significantly less shrinkage of the graft was observed in the test group after 6 months (P = 0.03). Clinical periodontal parameters at the neighboring teeth were stable over the follow-up period and did not differ between groups.
CONCLUSIONS: Augmentation of single tooth gaps with moderate ridge defects in the anterior maxilla was successfully performed using both techniques. However, after 6 months, sites treated by the pediculated graft were superior in maintaining the initially augmented volume and showed less shrinkage of the graft. This could be attributed to better perfusion of the pediculated graft.

Abstract

OBJECTIVES: To test whether or not vascularized interpositional periosteal-connective tissue grafts are as successful as free subepithelial connective tissue grafts in augmenting volume defects in the anterior maxilla.
MATERIAL AND METHODS: Twenty subjects with Seibert class 1 ridge defects in the anterior maxilla were randomly, equally assigned to augmentation by vascularized interpositional periosteal-connective tissue graft (test) or free subepithelial connective tissue graft (control). Clinical periodontal parameters at teeth adjacent to the gap were recorded, and conventional impressions were taken prior to surgery (baseline = t0 ) and 1 (t1 ), 3 (t3 ) and 6 (t6 ) months after surgery. The casts were optically scanned, digitized and analyzed for ridge contour changes in the augmented area. Data were subjected to nonparametric statistics.
RESULTS: The contour changes in labial distance between baseline and follow-up for the control group were (median, range) 1 mm, 0.37-1.45 (t0 -t1 ); 1.18 mm, 0.39-1.40 (t0 -t3 ); and 0.63 mm, 0.28-1.22 (t0 -t6 ) and for test group 1.21 mm, 0.74-2.47 (t0 -t1 ); 1.26 mm, 0.50-1.71 (t0 -t3 ); and 1.18 mm, 0.16-1.75 (t0 -t6 ). Significantly less shrinkage of the graft was observed in the test group after 6 months (P = 0.03). Clinical periodontal parameters at the neighboring teeth were stable over the follow-up period and did not differ between groups.
CONCLUSIONS: Augmentation of single tooth gaps with moderate ridge defects in the anterior maxilla was successfully performed using both techniques. However, after 6 months, sites treated by the pediculated graft were superior in maintaining the initially augmented volume and showed less shrinkage of the graft. This could be attributed to better perfusion of the pediculated graft.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Center for Dental Medicine > Clinic for Fixed and Removable Prosthodontics
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2015
Deposited On:26 May 2014 15:12
Last Modified:05 Apr 2016 17:53
Publisher:Wiley-Blackwell
ISSN:0905-7161
Additional Information:This is the accepted version of the following article: Journal of Clinical Periodontology (2014), Epub ahead of print, which has been published in final form at http://onlinelibrary.wiley.com/doi/10.1111/clr.12368/abstract
Publisher DOI:https://doi.org/10.1111/clr.12368
PubMed ID:24720375

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