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医用级半水硫酸钙在人类拔牙窝愈合中的应用:3个月时的临床和组织学观察

Medical grade calcium sulfate hemihydrate in healing of human extraction sockets: clinical and histological observations at 3 months.

作者信息

Guarnieri Renzo, Pecora Gabriele, Fini Milena, Aldini Nicolo' Nicoli, Giardino Roberto, Orsini Giovanna, Piattelli Adriano

机构信息

Department of Experimental Surgery, Research Institute Codivilla-Putti, Rizzoli Orthopaedic Institute, Bologna, Italy.

出版信息

J Periodontol. 2004 Jun;75(6):902-8. doi: 10.1902/jop.2004.75.6.902.

Abstract

BACKGROUND

Following tooth extraction, remodeling and resorption of the alveolar bone at the extraction site characterize wound healing. This produces a reduction in ridge volume and difficulties in delayed placement of implants in an ideal position. Medical grade calcium sulfate hemihydrate (MGCSH) has been proposed as a graft material in extraction sockets to minimize the reduction in ridge volume. The aim of the present study was to investigate the influence of MGCSH on the histopathologic pattern of intrasocket regenerated bone and to evaluate histologically the healed MGCSH grafted extraction socket site 3 months postextraction

METHODS

MGCSH was grafted in 10 fresh human extraction sockets in 10 patients. Five post-extraction sockets were used as controls. At 3 months a cylindrical tissue specimen, 2.5 mm in diameter, was trephined from the previously grafted site followed by implant placement. Non-decalcified specimens were sectioned at a cross-horizontal plane and stained with fast green, toluidine blue, and Van Kossa stains for histological and histomorphometrical examination.

RESULTS

Histologically, MGCSH was not observed in most of the specimens. Newly formed bone with lamellar arrangements was identified in all the horizontal sections with no difference between apical, medium, and coronal areas. The mean trabecular area in the coronal sections was 58.6% +/- 9.2%; in the medium sections, 58.1% +/- 6.2%; and in the apical sections, 58.3% +/- 7.8%. The differences were not statistically significant.

CONCLUSION

MGCSH seems to be an ideal graft material in extraction socket bone regeneration because it is almost completely resorbable, and it allows a new trabecular bone arrangement at 3 months.

摘要

背景

拔牙后,拔牙部位牙槽骨的重塑和吸收是伤口愈合的特征。这会导致牙槽嵴体积减小,并难以将种植体延迟放置在理想位置。医用级半水硫酸钙(MGCSH)已被提议作为拔牙窝的移植材料,以尽量减少牙槽嵴体积的减小。本研究的目的是调查MGCSH对拔牙窝内再生骨组织病理学模式的影响,并在拔牙后3个月对愈合的MGCSH移植拔牙窝部位进行组织学评估。

方法

将MGCSH植入10例患者的10个新鲜人类拔牙窝中。5个拔牙后窝作为对照。3个月时,从先前移植的部位钻取一个直径2.5毫米的圆柱形组织标本,随后植入种植体。对未脱钙的标本进行水平横切,并用固绿、甲苯胺蓝和范科萨染色进行组织学和组织形态计量学检查。

结果

组织学上,大多数标本中未观察到MGCSH。在所有水平切片中均发现了具有板层排列的新形成骨,根尖、中部和冠部区域之间无差异。冠部切片的平均小梁面积为58.6%±9.2%;中部切片为58.1%±6.2%;根尖切片为58.3%±7.8%。差异无统计学意义。

结论

MGCSH似乎是拔牙窝骨再生的理想移植材料,因为它几乎完全可吸收,并能在3个月时形成新的小梁骨排列。

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