Date on Master's Thesis/Doctoral Dissertation

8-2012

Document Type

Master's Thesis

Degree Name

M.S.

Department

Oral Biology

Committee Chair

Greenwell, Henry

Author's Keywords

Dental implant; Connective tissue graft; Acellular dermal matrix; Tissue thickness; Laser-lok; Alloderm

Subject

Dental implants; Gums--Surgery; Bone-grafting

Abstract

Aims. The primary aims of this randomized, controlled, blinded clinical trial were to compare the hard and soft tissue response following either a connective tissue (CT) or acellular dermal matrix (ADM) graft placed simultaneously with a laser-grooved implant. Methods. Twenty-four patients received a single tooth implant in the maxillary anterior that was bordered by two teeth. Twelve patients were randomly selected, using to coin toss, to receive either an ADM (test) or a CT (control) graft. At the 2-month uncovering appointment a lab constructed provisional was placed. At 4 months, following 2 months of tissue shaping, a fixture level impression was taken to capture the emergence profile. The final restoration was fabricated and placed. Final measurements were taken at 12 months. Results. Soft tissue thickness at 4 months was 3.1 mm at the crest for both CT and ADM groups; although ADM showed a greater increase in thickness from implant placement. Results. Soft tissue thickness at 4 months was 3.1 mm at the crest for both CT and ADM groups; although ADM showed a greater increase in thickness from implant placement. Facial recession at 6 months for the ADM group was 0.6 ± 0.5 mm and the CT group was 0.5 ± 0.5 mm (p > 0.05). Gingival margin harmony was 40% (2 of 5) for the ADM group and 50% (3 of 6) for the CT group. Using the Jemt papilla index, the ADM group had ~ 50% papilla fill in 80% of sites (8 of 10) while the CT group had 83% (10 of 12) of sites. Papilla harmony was achieved in 20% (1 of 5) of cases in the ADM group and 50% (3 of 6) for the CT group. Implant platform to osseous crest, at 6 months, for the ADM group was 0.4 ± 0.5 mm for both the mesial and distal, respectively, while the CT group was 0.5 ± 0.4 mm for the mesial and 0.5 ± OJ mm for the distal (p < 0.05). The Pink Esthetic Score was 10.9 ± 0.9 for the ADM group and 11.8 ± 1.3 for the CT group. The White Esthetic score was 8.0 ± 2.0 mm for the ADM group and 703 ± 1.3 mm for the CT group. Patient's subjective esthetic scores showed patients were equally satisfied with both treatment groups. Conclusions. Facial recession and gingival margin harmony were similar for both treatment groups. Jemt papilla index scores and papilla harmony were similar for both groups. Loss of osseous crest on the mesial and distal of the implants was slightly greater for the laser group but was not statistically different from the standard group. Subjective patient assessment of esthetics using the Visual Analog Scale was similar for both groups.

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