歯槽骨再建術後に挿入された即時インプラントと遅延インプラントにおける骨および軟組織の変化。無作為化比較臨床試験。第一部：審美的な結果

Bone and Soft Tissue Modifications in Immediate Implants Versus Delayed Implants Inserted Following Alveolar Ridge Preservation: A Randomized Controlled Clinical Trial. Part I: Esthetic Outcomes.

抄録

上顎前歯部（小臼歯から小臼歯まで）の1歯の抜歯とインプラントへの置換を必要とした患者48名について、1年間にわたる軟組織の変化を評価した。患者を無作為に2群に分けた．A 群では，抜歯後すぐにインプラントを埋入し，骨とインプラントの隙間を牛骨ミネラルで埋めた．B 群では，抜歯後に歯槽堤保存法を行い，4 ヵ月後にインプラントを埋入した．抜歯当日（T0）と抜歯後1年（T1）に，両群の軟組織水平幅，中顔面乳頭レベル，中顔面歯肉レベル，Pink Esthetic Scoreを評価した．その結果，いずれの項目においても群間差は認められなかった．T0とT1の軟組織水平幅に統計学的に有意な差が認められた。両手術の臨床結果は類似しており、経時的に比較可能であった。軟組織輪郭の安定性を評価し、2つの術式の具体的な適応症を考慮すると、即時埋入と段階的埋入による歯槽堤保存術のどちらかを選択することが可能である。

Soft tissue changes were evaluated over a period of 1 year in 48 patients who required extraction of a single tooth in the anterior maxillary arch (premolar to premolar) and its replacement with an implant. The patients were randomly divided into two groups: In group A, an immediate postextraction implant was placed, and the bone-to-implant gap was filled with bovine bone mineral; in group B, the alveolar ridge preservation technique was performed after extraction, and the implant was placed 4 months later. On the day of tooth extraction (T0) and 1 year after tooth extraction (T1), the soft tissue horizontal width, mesial and distal papillary levels, midfacial gingival level, and Pink Esthetic Score were evaluated in both groups. No significant differences were observed between the groups in any of the considered parameters. Statistically significant differences were found in the soft tissue horizontal width between T0 and T1. The clinical results of the two procedures were similar and comparable over time. When evaluating the stability of the soft tissue contour, and considering the specific indications of the two techniques, it is possible to choose either an immediate implant or an alveolar ridge preservation technique with staged placement.