Fickl Stefan, Zuhr Otto, Wachtel Hannes, Bolz Wolfgang, Huerzeler Markus
Private Institute for Periodontology and Implantology, Munich, Germany.
J Clin Periodontol. 2008 Apr;35(4):356-63. doi: 10.1111/j.1600-051X.2008.01209.x.
The aim of this study is to evaluate whether tooth extraction without the elevation of a muco-periosteal flap has advantageous effects on the resorption rate after tooth extraction.
In five beagle dogs polyether impressions were taken before the surgery. The roots of the first and second pre-molars (P(1) and P(2)) were extracted and the sites were assigned to one of the following treatments: treatment group (Tx) 1, no treatment; Tx 2, surgical trauma (flap elevation and repositioning); Tx 3, the extraction socket was filled with BioOss Collagen and closed with a free soft-tissue graft; Tx 4, after flap elevation and repositioning, the extraction socket was treated with BioOss Collagen and a free soft-tissue graft. Impressions were taken 2 and 4 months after surgery. The casts were scanned, matched together with baseline casts and evaluated with digital image analysis.
The "flapless groups" demonstrated significant lower resorption rates both when using socket-preservation techniques and without. Furthermore, socket-preservation techniques yielded better results compared with not treating the socket.
The results demonstrate that leaving the periosteum in place decreases the resorption rate of the extraction socket. Furthermore, the treatment of the extraction socket with BioOss Collagen and a free gingival graft seems beneficial in limiting the resorption process after tooth extraction.
本研究旨在评估不掀起粘骨膜瓣拔牙对拔牙后牙槽骨吸收速率是否具有有利影响。
对5只比格犬在手术前制取聚醚印模。拔除第一和第二前磨牙（P(1)和P(2)）的牙根，拔牙位点被分配至以下治疗组之一：治疗组（Tx）1，不进行处理；Tx 2，手术创伤（掀起瓣并复位）；Tx 3，拔牙窝用BioOss胶原填充并用游离软组织瓣封闭；Tx 4，掀起瓣并复位后，拔牙窝用BioOss胶原和游离软组织瓣处理。在术后2个月和4个月制取印模。对模型进行扫描，与基线模型匹配，并通过数字图像分析进行评估。
无论是采用牙槽窝保存技术还是未采用该技术，“无瓣组”的牙槽骨吸收速率均显著更低。此外，与不处理牙槽窝相比，牙槽窝保存技术产生了更好的结果。
结果表明保留骨膜可降低拔牙窝的吸收速率。此外，用BioOss胶原和游离牙龈瓣处理拔牙窝似乎有利于限制拔牙后的吸收过程。
