Serino Giovanni, Rao Walter, Iezzi Giovanna, Piattelli Adriano
Department of Periodontology, Borås Hospital; Research and Development Unit, Borås, Sweden.
Clin Oral Implants Res. 2008 Jan;19(1):26-31. doi: 10.1111/j.1600-0501.2007.01311.x. Epub 2007 Oct 17.
The aim of this study was to evaluate (i) the degree of bone mineralization in the alveolar sockets 3 months following the use of a bio-absorbable graft material and (ii) the degree of resorption of the grafted material.
Twenty patients, undergoing periodontal therapy, participated in this study. All patients were scheduled for extraction of one or more compromised monoradicular teeth and scheduled for replacement of the extracted teeth with dental implants.
Following elevation of full-thickness flaps and extraction of teeth, the alveolar sockets were filled with a bioabsorbable polylactide-polyglycolide acid sponge (Fisiograft) (Test group - T) or natural healing by clot formation was allowed (Control group - C). The flaps were sutured with no attempt to achieve primary closure of the surgical wound. Re-entry for implant surgery was performed 3 months following the extractions.
Fifteen biopsies (seven T and nine C) were harvested from the sites where the implants were placed. The biopsies harvested from the T sites revealed that the alveolar sockets healed with newly trabecular bone, highly mineralized and well structured. Particles of the grafted material could not be identified in any of the T biopsies. The bone formed in the C sites was also well structured, with a slightly minor percentage of mineralized bone. In both T and C biopsies, the apical portion presented a higher degree of mineralization compared with the coronal portion.
The results of this study indicated that the use of a bio-absorbable synthetic sponge of polylactide-polyglycolide acid did not interfere with the formation of new bone in the alveolar sockets and that the characteristics of the 3-month newly formed bone seemed to be optimal for dental implants' insertion. The biocompatibility, safety and characteristics of Fisiograft suggest that the material is suitable for filling alveolar sockets following extractions, to prevent volume reduction and collapse of the overlying soft tissue flaps.
本研究旨在评估(i)使用生物可吸收移植材料3个月后牙槽窝内的骨矿化程度,以及(ii)移植材料的吸收程度。
20名接受牙周治疗的患者参与了本研究。所有患者均计划拔除一颗或多颗患单根牙,并计划用牙种植体替代拔除的牙齿。
在掀起全厚瓣并拔除牙齿后,牙槽窝用生物可吸收聚乳酸-聚乙醇酸海绵(Fisiograft)填充(试验组-T),或允许通过血凝块形成自然愈合(对照组-C)。缝合瓣,不试图实现手术伤口的一期闭合。拔牙后3个月进行种植手术再入路。
从种植体植入部位采集了15份活检标本(7份T组和9份C组)。从T组部位采集的活检标本显示,牙槽窝用新的小梁骨愈合,矿化程度高且结构良好。在任何T组活检标本中均未发现移植材料颗粒。C组部位形成的骨结构也良好,矿化骨的比例略低。在T组和C组活检标本中,根尖部分的矿化程度均高于冠部。
本研究结果表明,使用聚乳酸-聚乙醇酸生物可吸收合成海绵不会干扰牙槽窝内新骨的形成,且3个月新形成骨的特征似乎最适合植入牙种植体。Fisiograft的生物相容性、安全性和特性表明,该材料适用于拔牙后填充牙槽窝,以防止覆盖的软组织瓣体积减小和塌陷。