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两种不同生物材料保存牙槽嵴后放射学牙槽骨变化。

Radiographic alveolar bone changes following ridge preservation with two different biomaterials.

机构信息

Periodontology Unit, Eastman Dental Institute, University College London, London, UK.

出版信息

Clin Oral Implants Res. 2011 Apr;22(4):416-23. doi: 10.1111/j.1600-0501.2010.02154.x.

Abstract

OBJECTIVES

The aim of this randomized controlled trial was to evaluate radiographical bone changes following alveolar ridge preservation with a synthetic bone substitute or a bovine xenograft.

METHODS

Alveolar ridge preservation was performed in 27 patients randomized in two groups. In the test group (n=14), the extraction socket was treated with Straumann bone ceramic(®) (SBC) and a collagen barrier membrane (Bio-Gide(®)), whereas in the control group (n=13) with deproteinized bovine bone mineral and the same barrier. Standardized periapical X-rays were taken at 4 time points, BL: after tooth extraction, GR: immediately after socket grafting, 4M: 16 weeks, 8M: 32 weeks post-operatively. The levels of the alveolar bone crest at the mesial (Mh), and distal (Dh) and central aspects of the socket were measured at all time points. All the radiographs obtained were subtracted from the follow-up images. The gain, loss and unchanged areas in terms of grey values were tested for significant difference between the two groups.

RESULTS

In the test group, the Mh and Dh showed a mean difference (± standard deviation) of 0.9 ± 1.2 and 0.7 ± 1.8 mm, respectively, among BL-8M. In the control group, the Mh and Dh showed a mean difference of 0.4 ± 1.3 and 0.7 ± 1.3 mm, respectively (P>0.05). Both treatments presented similar gain in grey values between BL-GR, BL-4M and BL-8M. The SBC presented less loss in grey values between BL-4M and BL-8M (P<0.05). Radiographic assessment underestimated the intrasurgical measurements (mesial and distal) of an average 0.3 mm (95% CI, 0.02-0.6).

CONCLUSION

Both types of bone grafts presented similar radiographic alveolar bone changes when used for alveolar ridge preservation.

摘要

目的

本随机对照试验旨在评估使用合成骨替代物或牛异种移植物进行牙槽嵴保存后的影像学骨变化。

方法

将 27 名患者随机分为两组进行牙槽嵴保存。在实验组(n=14)中,拔牙窝采用 Straumann 骨陶瓷(SBC)和胶原屏障膜(Bio-Gide(®))处理,而在对照组(n=13)中则采用脱蛋白牛骨矿物质和相同的屏障处理。在 4 个时间点(BL:拔牙后,GR:即刻牙槽窝移植后,4M:16 周,8M:术后 32 周)拍摄标准化根尖 X 线片。在所有时间点测量牙槽嵴顶在近中(Mh)、远中(Dh)和牙槽窝中央的水平。所有获得的 X 光片均从随访图像中减去。测试两组之间在灰度值方面的增益、损失和不变区域是否存在显著差异。

结果

在实验组中,Mh 和 Dh 在 BL-8M 之间的平均差值(±标准差)分别为 0.9±1.2 和 0.7±1.8mm。在对照组中,Mh 和 Dh 的平均差值分别为 0.4±1.3 和 0.7±1.3mm(P>0.05)。两种治疗方法在 BL-GR、BL-4M 和 BL-8M 之间均表现出相似的灰度值增加。SBC 在 BL-4M 和 BL-8M 之间的灰度值损失较少(P<0.05)。影像学评估低估了手术中近中(和远中)的测量值,平均为 0.3mm(95%CI,0.02-0.6)。

结论

在进行牙槽嵴保存时,两种类型的骨移植物均表现出相似的影像学牙槽骨变化。

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