Kesmas Sasikarn, Swasdison Somporn, Yodsanga Somchai, Sessirisombat Somchai, Jansisyanont Pornchai
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Nov;110(5):e24-36. doi: 10.1016/j.tripleo.2010.06.006.
The objective of this study was to evaluate clinically, histologically and radiographically a ridge preservation technique used on extraction sockets grafted with biphasic calcium phosphate (BCP) and a resorbable collagen membrane.
Patients having a labial socket wall defect more than one-third in mesio-distal socket width after maxillary central incisor tooth extraction were included. The labial defect was sealed with resorbable collagen membrane and the defect filled with BCP. The grafted socket was covered with a resorbable collagen wound dressing material. The treated sockets were evaluated after a 4-month healing period when implants were placed and followed for up to 12 months.
There were 8 subjects enrolled in this study. A statistical difference was found only in ridge width reduction at 3 mm below the cement-enamel junction of the adjacent teeth (P < .05) with 1 mm widening at 8 mm. The amount of new bone formation was extensively varied with diminutive graft remnants. Most cells in the connective tissue were osteopontin positive indicating they were osteoblast-like cells. A declination in the radiodensity of the grafted socket was observed during the analyzed period.
Ridge preservation with BCP with collagen membrane can be used as an alternative treatment for maintaining ridge dimension before implant placement.
本研究旨在从临床、组织学和影像学方面评估一种应用于种植体植入的牙槽嵴保存技术,该技术使用双相磷酸钙(BCP)和可吸收胶原膜对拔牙窝进行植骨。
纳入上颌中切牙拔除后唇侧牙槽窝壁缺损超过近远中牙槽窝宽度三分之一的患者。唇侧缺损用可吸收胶原膜封闭,缺损处填充BCP。植骨后的牙槽窝用可吸收胶原伤口敷料覆盖。在植入种植体时,经过4个月的愈合期后对治疗后的牙槽窝进行评估,并随访长达12个月。
本研究共纳入8名受试者。仅在相邻牙齿牙骨质-釉质界下方3mm处的牙槽嵴宽度减小方面发现有统计学差异(P <.05),在8mm处牙槽嵴增宽1mm。新骨形成量差异很大,移植残余物较少。结缔组织中的大多数细胞骨桥蛋白呈阳性,表明它们是成骨样细胞。在分析期间观察到植骨牙槽窝的放射密度下降。
使用BCP和胶原膜进行牙槽嵴保存可作为种植体植入前维持牙槽嵴尺寸的一种替代治疗方法。