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Horizontal stability of connective tissue grafts at the buccal aspect of single implants : a 1-year prospective case series

Thomas De Bruyckere (UGent) , Aryan Eghbali (UGent) , Faris Younes (UGent) , Hugo De Bruyn (UGent) and Jan Cosyn (UGent)
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Abstract
Aim: To clinically evaluate the horizontal stability of a connective tissue graft (CTG) at the buccal aspect of single implants (1); to compare actual gingival thickness between thin and thick gingival biotype (2). Materials and Methods: Periodontally healthy non-smoking patients with a single implant in the anterior maxilla (15-25) were selected for a prospective case series. All demonstrated a horizontal alveolar defect and were in need of contour augmentation by means of CTG for aesthetic reasons. Patients were enrolled 3months after implant surgery and had been provided with a provisional screw-retained crown. CTG was inserted in the buccal mucosa via the envelope technique using one intrasulcular incision. An ultrasonic device was used to evaluate mucosal thickness (MT) at the buccal aspect. MT was assessed at t0 (before CTG), t1 (immediately after CTG), t2 (2weeks after CTG=suture removal), t3 (3months after CTG=permanent crown installation) and t4 (1year after implant placement). The gingival biotype was categorized as thin or thick based on the transparency of a periodontal probe through the soft tissues while probing the buccal sulcus of the contra-lateral tooth. Gingival thickness (GT) was measured at the contra-lateral tooth using the same ultrasonic device. Results: Thirty-seven patients (19 men, 18 women; mean age 38) met the selection criteria and consented to the treatment. Mean soft tissue gain immediately after CTG was on average 1.07mm (SD 0.49). What remained of this tissue gain after 1year was on average 0.97mm (SD 0.48; 90.5%). Hence, mean soft tissue loss amounted to 0.10mm (SD 0.23; 9.5%; p=0.015) with no significant difference between patients with a thin or thick biotype (p0.290). Patients with a thin biotype had a mean GT of 1.02mm (SD 0.21), whereas GT was on average 1.32mm (SD 0.31) in subjects with a thick biotype (p=0.004). Conclusion: Connective tissue graft substantially thickens the peri-implant mucosa with acceptable stability over a 1-year period.
Keywords
connective tissue graft, contour augmentation, dental implant, single tooth, ANTERIOR MAXILLA, SOFT-TISSUE, RIDGE PRESERVATION, PERIODONTAL BIOTYPE, TOOTH IMPLANTS, DIMENSIONS, THICKNESS, MUCOSA, HARD

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Chicago
De Bruyckere, Thomas, Aryan Eghbali, Faris Younes, Hugo De Bruyn, and Jan Cosyn. 2015. “Horizontal Stability of Connective Tissue Grafts at the Buccal Aspect of Single Implants : a 1-year Prospective Case Series.” Journal of Clinical Periodontology 42 (9): 876–882.
APA
De Bruyckere, T., Eghbali, A., Younes, F., De Bruyn, H., & Cosyn, J. (2015). Horizontal stability of connective tissue grafts at the buccal aspect of single implants : a 1-year prospective case series. JOURNAL OF CLINICAL PERIODONTOLOGY, 42(9), 876–882.
Vancouver
1.
De Bruyckere T, Eghbali A, Younes F, De Bruyn H, Cosyn J. Horizontal stability of connective tissue grafts at the buccal aspect of single implants : a 1-year prospective case series. JOURNAL OF CLINICAL PERIODONTOLOGY. 2015;42(9):876–82.
MLA
De Bruyckere, Thomas, Aryan Eghbali, Faris Younes, et al. “Horizontal Stability of Connective Tissue Grafts at the Buccal Aspect of Single Implants : a 1-year Prospective Case Series.” JOURNAL OF CLINICAL PERIODONTOLOGY 42.9 (2015): 876–882. Print.
@article{6962139,
  abstract     = {Aim: To clinically evaluate the horizontal stability of a connective tissue graft (CTG) at the buccal aspect of single implants (1); to compare actual gingival thickness between thin and thick gingival biotype (2). 
Materials and Methods: Periodontally healthy non-smoking patients with a single implant in the anterior maxilla (15-25) were selected for a prospective case series. All demonstrated a horizontal alveolar defect and were in need of contour augmentation by means of CTG for aesthetic reasons. Patients were enrolled 3months after implant surgery and had been provided with a provisional screw-retained crown. CTG was inserted in the buccal mucosa via the envelope technique using one intrasulcular incision. An ultrasonic device was used to evaluate mucosal thickness (MT) at the buccal aspect. MT was assessed at t0 (before CTG), t1 (immediately after CTG), t2 (2weeks after CTG=suture removal), t3 (3months after CTG=permanent crown installation) and t4 (1year after implant placement). The gingival biotype was categorized as thin or thick based on the transparency of a periodontal probe through the soft tissues while probing the buccal sulcus of the contra-lateral tooth. Gingival thickness (GT) was measured at the contra-lateral tooth using the same ultrasonic device. 
Results: Thirty-seven patients (19 men, 18 women; mean age 38) met the selection criteria and consented to the treatment. Mean soft tissue gain immediately after CTG was on average 1.07mm (SD 0.49). What remained of this tissue gain after 1year was on average 0.97mm (SD 0.48; 90.5\%). Hence, mean soft tissue loss amounted to 0.10mm (SD 0.23; 9.5\%; p=0.015) with no significant difference between patients with a thin or thick biotype (p0.290). Patients with a thin biotype had a mean GT of 1.02mm (SD 0.21), whereas GT was on average 1.32mm (SD 0.31) in subjects with a thick biotype (p=0.004). 
Conclusion: Connective tissue graft substantially thickens the peri-implant mucosa with acceptable stability over a 1-year period.},
  author       = {De Bruyckere, Thomas and Eghbali, Aryan and Younes, Faris and De Bruyn, Hugo and Cosyn, Jan},
  issn         = {0303-6979},
  journal      = {JOURNAL OF CLINICAL PERIODONTOLOGY},
  keyword      = {connective tissue graft,contour augmentation,dental implant,single tooth,ANTERIOR MAXILLA,SOFT-TISSUE,RIDGE PRESERVATION,PERIODONTAL BIOTYPE,TOOTH IMPLANTS,DIMENSIONS,THICKNESS,MUCOSA,HARD},
  language     = {eng},
  number       = {9},
  pages        = {876--882},
  title        = {Horizontal stability of connective tissue grafts at the buccal aspect of single implants : a 1-year prospective case series},
  url          = {http://dx.doi.org/10.1111/jcpe.12448},
  volume       = {42},
  year         = {2015},
}

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