Department of Periodontics, Dental School, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
Clin Oral Implants Res. 2012 Oct;23(10):1198-204. doi: 10.1111/j.1600-0501.2011.02288.x. Epub 2011 Aug 18.
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.
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.
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).
Socket preservation using either NCHA or DBBM in combination with collagen membrane, results in similar, limited horizontal ridge width alterations following tooth extraction.
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。
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。
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)。
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。