Soft Tissue Alterations in Esthetic Postextraction Sites: A 3-Dimensional Analysis
Soft Tissue Alterations in Esthetic Postextraction Sites: A 3-Dimensional Analysis
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DOI：
10.1177/0022034515592869
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发表时间：
2015-09-01
影响因子：
7.6
通讯作者：
Buser, D.
中科院分区：
文献类型：
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作者：
Chappuis, V.;Engel, O.;Buser, D.
拔牙后美容区面部软组织和骨组织的尺寸变化对于种植治疗的成功结果起着至关重要的作用。这项前瞻性研究首次调查了 8 周愈合期间软组织尺寸与底层骨骼解剖结构之间的相互作用。该分析基于在 8 周愈合期间使用数字印模和锥形束计算机断层扫描对软组织和骨组织进行连续 3 维数字表面模型叠加。拔除时薄骨和厚骨表型的软组织厚度相似，平均分别为 0.7 毫米和 0.8 毫米。有趣的是，薄骨表型显示，8周愈合期后软组织厚度增加了7倍，而厚骨表型中，软组织尺寸保持不变。观察到的薄骨表型自发软组织增厚导致垂直软组织损失仅 1.6 毫米，掩盖了潜在的 7.5 毫米垂直骨吸收。由于自发性软组织增厚，在第 2、4、6 和 8 周时，薄骨和厚骨表型之间的总组织损失没有显着差异。超过 51% 的尺寸变化发生在愈合后 2 周内。尽管拔牙后在薄骨表型中观察到的自发性软组织增厚通过掩盖真正的骨缺陷而掩盖了明显的潜在骨吸收模式，但自发性软组织增厚为后续骨再生和在审美需求较高的部位进行种植治疗提供了优势（Clinicaltrials.gov NCT02403700）。
Dimensional alterations of the facial soft and bone tissues following tooth extraction in the esthetic zone play an essential role to achieve successful outcomes in implant therapy. This prospective study is the first to investigate the interplay between the soft tissue dimensions and the underlying bone anatomy during an 8-wk healing period. The analysis is based on sequential 3-dimensional digital surface model superimpositions of the soft and bone tissues using digital impressions and cone beam computed tomography during an 8-wk healing period. Soft tissue thickness in thin and thick bone phenotypes at extraction was similar, averaging 0.7 mm and 0.8 mm, respectively. Interestingly, thin bone phenotypes revealed a 7-fold increase in soft tissue thickness after an 8-wk healing period, whereas in thick bone phenotypes, the soft tissue dimensions remained unchanged. The observed spontaneous soft tissue thickening in thin bone phenotypes resulted in a vertical soft tissue loss of only 1.6 mm, which concealed the underlying vertical bone resorption of 7.5 mm. Because of spontaneous soft tissue thickening, no significant differences were detected in the total tissue loss between thin and thick bone phenotypes at 2, 4, 6, and 8 wk. More than 51% of these dimensional alterations occurred within 2 wk of healing. Even though the observed spontaneous soft tissue thickening in thin bone phenotypes following tooth extraction conceals the pronounced underlying bone resorption pattern by masking the true bone deficiency, spontaneous soft tissue thickening offers advantages for subsequent bone regeneration and implant therapies in sites with high esthetic demand (Clinicaltrials.gov NCT02403700).