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异体骨基质与自体骨屑联合钛增强e-PTFE膜用于垂直牙槽嵴增高的临床和组织学评价:一项前瞻性初步研究。

Clinical and histologic evaluation of allogeneic bone matrix versus autogenous bone chips associated with titanium-reinforced e-PTFE membrane for vertical ridge augmentation: a prospective pilot study.

作者信息

Fontana Filippo, Santoro Franco, Maiorana Carlo, Iezzi Giovanna, Piattelli Adriano, Simion Massimo

机构信息

Department of Implantology, Clinica Odontoiatrica, University of Milan, School of Dentistry, Milan, Italy.

出版信息

Int J Oral Maxillofac Implants. 2008 Nov-Dec;23(6):1003-12.

Abstract

PURPOSE

To compare clinically and histologically an allogeneic bone matrix to autogenous bone chips in the vertical ridge augmentation technique using titanium-reinforced e-PTFE membranes.

MATERIALS AND METHODS

The study protocol was designed to include patients with bilateral posterior mandibular partial edentulism. Patients were treated with a split-mouth design approach: each side was randomly assigned to the test group (titanium-reinforced e-PTFE membrane and allogeneic bone matrix) or to the control group (titanium-reinforced e-PTFE membrane and autogenous bone chips). Different clinical parameters including the amount of vertically regenerated bone (DSB) and biologic complications were recorded. Histomorphometric analysis and the bone-implant contact percentage were performed.

RESULTS

Five female patients were enrolled in the study. Ten edentulous sites were vertically augmented and 25 implants were inserted (13 test group, 12 control group) with a staged approach. In the test group no membrane was exposed. The mean bone regeneration was 4.70 mm (SD 0.48 mm). All 13 implants appeared clinically stable. In the control group, 1 membrane was exposed after 2 months. The mean crestal bone regeneration was 4.10 mm (SD 0.88 mm). All 12 implants were stable at the abutment connection. Nine biopsy specimens from the regenerated areas were evaluated. Vertical bone regeneration was evident in both groups since all the samples demonstrated trabecular bone with different degrees of maturation and mineralization in the regenerated area.

CONCLUSION

Within the limits of this study based on 5 patients, it appears that the behavior of the allogeneic bone matrix is similar to that of autogenous bone chips when used for vertical ridge augmentation by means of guided bone regeneration techniques. Both grafts demonstrated analogous histologic characteristics. Nevertheless, long-term clinical studies are needed to confirm these preliminary results.

摘要

目的

在使用钛增强e-PTFE膜的垂直牙槽嵴增高技术中,对同种异体骨基质与自体骨屑进行临床和组织学比较。

材料与方法

研究方案设计纳入双侧下颌后牙部分牙列缺失患者。患者采用分口设计方法进行治疗:每侧随机分为试验组(钛增强e-PTFE膜和同种异体骨基质)或对照组(钛增强e-PTFE膜和自体骨屑)。记录包括垂直再生骨量(DSB)和生物并发症在内的不同临床参数。进行组织形态计量分析和骨-种植体接触百分比测定。

结果

5名女性患者纳入研究。采用分期方法对10个无牙位点进行垂直增高,并植入25枚种植体(试验组13枚,对照组12枚)。试验组无膜暴露。平均骨再生为4.70毫米(标准差0.48毫米)。所有13枚种植体临床均稳定。对照组有1枚膜在2个月后暴露。平均嵴顶骨再生为4.10毫米(标准差0.88毫米)。所有12枚种植体在基台连接时均稳定。对9份来自再生区域的活检标本进行评估。两组均有明显的垂直骨再生,因为所有样本在再生区域均显示出不同程度成熟和矿化的小梁骨。

结论

在这项基于5名患者的研究范围内,似乎同种异体骨基质在通过引导骨再生技术用于垂直牙槽嵴增高时,其表现与自体骨屑相似。两种移植物均表现出类似的组织学特征。然而,需要长期临床研究来证实这些初步结果。

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