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采用合成纳米羟基磷灰石与牛异种骨对比保存拔牙窝的临床、组织学和组织形态计量学评估:一项随机临床试验。

Clinical, histologic and histomorphometric evaluation of socket preservation using a synthetic nanocrystalline hydroxyapatite in comparison with a bovine xenograft: a randomized clinical trial.

机构信息

Department of Periodontics, Dental School, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Clin Oral Implants Res. 2012 Oct;23(10):1198-204. doi: 10.1111/j.1600-0501.2011.02288.x. Epub 2011 Aug 18.

DOI:10.1111/j.1600-0501.2011.02288.x
PMID:22092485
Abstract

OBJECTIVES

The aim of this study was to compare a nanocrystalline hydroxyapatite (NCHA), NanoBone(®) and a deproteinized bovine bone mineral (DBBM), Bio-Oss(®) with a collagen membrane on the horizontal ridge width alterations following tooth extraction, in addition to histologic aspects of the grafted extraction sockets.

MATERIAL AND METHODS

In this randomized clinical trial, 28 symmetrical, non-molar, extraction sockets using a split-mouth design in 12 patients (eight women and four men; aged 21-60; mean 44.6 ± 11.4 years), were randomly selected in the first group to be grafted with DBBM granules covered with a collagen membrane and in the other group grafted with NCHA covered with a collagen membrane. Following extraction horizontal ridge width was measured using caliper and was blindly compared to the dimensions measured prior to implant placement, at the 6- to 8-month follow-up. Subsequently, a 2 × 6 mm trephine core was obtained with aid of acrylic stent and routine histologic preparation was performed on the specimens.

RESULTS

The width of the DBBM group decreased from 7.75 ± 1.55 to 6.68 ± 1.85 mm (P < 0.05), whereas the width of the NCHA group decreased from 7.36 ± 1.94 to 6.43 ± 2.08 mm (P < 0.05). The mean between-group difference did not reach statistical significance (P = 0.62). Furthermore, histologic and histomorphometric analyses revealed 28.63 ± 12.53% vital bone in NCHA group vs. 27.35 ± 12.39% in DBBM group, and no statistically significant difference between the groups (P = 0.68).

CONCLUSION

Socket preservation using either NCHA or DBBM in combination with collagen membrane, results in similar, limited horizontal ridge width alterations following tooth extraction.

摘要

目的

本研究旨在比较纳米晶羟磷灰石(NCHA)、NanoBone(®)和脱蛋白牛骨矿物质(DBBM)、Bio-Oss(®)与胶原膜在拔牙后水平牙槽嵴宽度变化方面的差异,并对移植拔牙窝的组织学方面进行评估。

材料与方法

在这项随机临床试验中,选择了 12 名患者(8 名女性,4 名男性;年龄 21-60 岁;平均 44.6±11.4 岁)的 28 个对称、非磨牙、拔牙窝,采用分口设计,将这些拔牙窝随机分为两组:一组用胶原膜覆盖 DBBM 颗粒进行移植,另一组用胶原膜覆盖 NCHA 进行移植。拔牙后,使用卡尺测量水平牙槽嵴的宽度,并与植入前、6-8 个月随访时的测量值进行盲目比较。然后,使用丙烯酸支架获得 2×6mm 的环钻芯,并对标本进行常规组织学准备。

结果

DBBM 组的宽度从 7.75±1.55mm 减少至 6.68±1.85mm(P<0.05),而 NCHA 组的宽度从 7.36±1.94mm 减少至 6.43±2.08mm(P<0.05)。两组间的平均差异无统计学意义(P=0.62)。此外,组织学和组织形态计量学分析显示,NCHA 组的活骨比例为 28.63±12.53%,DBBM 组为 27.35±12.39%,两组间无统计学差异(P=0.68)。

结论

使用 NCHA 或 DBBM 联合胶原膜进行牙槽窝保存,在拔牙后会导致相似的、有限的水平牙槽嵴宽度变化。

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