Unit of Oral Development and Applied Oral Histology, Paecamed Research, Faculty of Medicine and Health Sciences, Dental School, University of Ghent, De Pintelaan 185, Ghent, Belgium.
Clin Implant Dent Relat Res. 2011 Mar;13(1):34-45. doi: 10.1111/j.1708-8208.2009.00184.x.
Various grafting materials have been designed to minimize edentulous ridge volume loss following tooth extraction by encouraging new bone formation in healing sockets. BoneCeramic® is a composite of hydroxyapatite and bèta-tricalcium phosphate with pores of 100-500 microns.
The aim of this study was to evaluate bone regeneration in healing sockets substituted with BoneCeramic® prior to implant procedures.
Fifteen extraction sockets were substituted with BoneCeramic® and 14 sockets were left to heal naturally in 10 patients (mean age 59.6 years). Biopsies were collected only from the implant recipient sites during surgery after healing periods ranging from 6-74 weeks (mean 22). In total, 24 biopsies were available; 10 from substituted and 14 from naturally healed sites. In one site, the implant was not placed intentionally and, in four substituted sites, implant placement had to be postponed due to inappropriate healing, hence from five sites biopsies were not available. Histological sections were examined by transmitted light microscope.
At the time of implant surgery, bone at substituted sites was softer than in controls, compromising initial implant stability. New bone formation at substituted sites was consistently poorer than in controls, presenting predominantly loose connective tissue and less woven bone.
The use of BoneCeramic® as a grafting material in fresh extraction sockets appears to interfere with normal healing processes of the alveolar bone. On the basis of the present preliminary findings, its indication as a material for bone augmentation, when implant placement is considered within 6-38 weeks after extraction, should be revised.
为了通过促进愈合牙槽骨中的新骨形成来最小化拔牙后无牙颌骨量的损失，已经设计了各种移植物。BoneCeramic®是一种由羟基磷灰石和β-磷酸三钙组成的复合材料，具有 100-500 微米的孔。
本研究旨在评估在植入手术前用 BoneCeramic®替代愈合牙槽骨时的骨再生情况。
10 名患者（平均年龄 59.6 岁）的 15 个拔牙窝被 BoneCeramic®替代，14 个拔牙窝自然愈合。在愈合期为 6-74 周（平均 22 周）后，仅在手术期间从植入物受区采集活检。共有 24 个活检标本，10 个取自替代区，14 个取自自然愈合区。在一个部位，未故意放置植入物，在 5 个替代部位中的 4 个部位，由于愈合不当，必须推迟植入物放置，因此，5 个部位没有活检标本。通过透射光显微镜检查组织学切片。
在植入手术时，替代部位的骨比对照组更软，从而影响初始植入物的稳定性。替代部位的新骨形成始终比对照组差，主要表现为疏松结缔组织和较少的编织骨。
在新鲜拔牙窝中使用 BoneCeramic®作为移植物似乎会干扰牙槽骨的正常愈合过程。基于目前的初步发现，当考虑在拔牙后 6-38 周内植入物时，应重新评估其作为骨增量材料的适应证。
