Fickl Stefan, Zuhr Otto, Wachtel Hannes, Kebschull Moritz, Hürzeler Markus B
Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, NY 10010, USA.
J Clin Periodontol. 2009 Oct;36(10):898-904. doi: 10.1111/j.1600-051X.2009.01463.x. Epub 2009 Aug 27.
The aim of this study was to histometrically assess alterations of the ridge following socket preservation alone and socket preservation with additional buccal overbuilding.
In five beagle dogs four extraction sites were randomly subjected to one of the following treatments: Tx 1: The socket was filled with BioOss Collagen and covered with a free gingival graft from the palate. Tx 2: The buccal bone plate was augmented using the GBR-technique, the socket was filled with BioOss Collagen and covered with a free gingival graft. Tx 3: The buccal bone plate was forced into a buccal direction using a manual bone spreader. The socket was filled with BioOss Collagen and covered with a free gingival graft from the palate. Tx 4: The socket was filled with BioOss Collagen and a combined free gingival/connective tissue graft was used to cover the socket and for buccal tissue augmentation. For each experimental site, two histological sections were subjected to histometric analysis and evaluated for (i) vertical bone dimensions and (ii) horizontal bone dimensions.
All treatment groups showed horizontal and vertical bone loss. The mean vertical bone loss of the buccal bone plate was significantly lower in Tx 4 than in the other groups, while no statistical significant differences could be detected among the groups in the horizontal dimension.
Overbuilding the buccal aspect in combination with socket preservation does not seem to be a suitable technique to compensate for the alterations after tooth extraction.
本研究旨在通过组织计量学评估单纯牙槽窝保存及牙槽窝保存联合颊侧加高术后牙槽嵴的变化。
在5只比格犬身上，4个拔牙位点被随机分配接受以下一种治疗：Tx 1：牙槽窝用BioOss胶原填充，并用腭部游离龈瓣覆盖。Tx 2：采用引导骨再生技术对颊侧骨板进行增量，牙槽窝用BioOss胶原填充，并用腭部游离龈瓣覆盖。Tx 3：用手动骨撑开器将颊侧骨板向颊侧推压。牙槽窝用BioOss胶原填充，并用腭部游离龈瓣覆盖。Tx 4：牙槽窝用BioOss胶原填充，并用游离龈/结缔组织联合瓣覆盖牙槽窝并进行颊侧组织增量。对每个实验位点制作两张组织学切片进行组织计量学分析，并评估（i）垂直骨尺寸和（ii）水平骨尺寸。
所有治疗组均出现水平和垂直骨吸收。Tx 4组颊侧骨板的平均垂直骨吸收明显低于其他组，而在水平维度上各治疗组之间未检测到统计学显著差异。
牙槽窝保存联合颊侧加高似乎并非补偿拔牙后牙槽嵴变化的合适技术。
