Morjaria Kushel R, Wilson Ron, Palmer Richard M
Postgraduate student, Department of Restorative Dentistry, Kings' College London Dental Institute, Floor 25 Tower Wing, Guy's Hospital Campus, London, UK Senior lecturer, Department of Restorative Dentistry, Kings' College London Dental Institute, Floor 25 Tower Wing, Guy's Hospital Campus, London, UK Professor of Implant Dentistry and Periodontology, Department of Restorative Dentistry, Kings' College London Dental Institute, Floor 25 Tower Wing, Guy's Hospital Campus, London, UK.
Clin Implant Dent Relat Res. 2014 Feb;16(1):1-20. doi: 10.1111/j.1708-8208.2012.00450.x. Epub 2012 Mar 8.
To assess whether the use of a graft and/or membrane post-tooth extraction improves healing of the site dimensionally, radiographically, and/or histologically.
MEDLINE and EMBASE and the Cochrane Central register of controlled trials (CENTRAL) were searched up until August 2011. Randomized controlled trials that included and compared healing post-tooth extraction between a control (no intervention) and a graft and/or membrane (test) were selected.
Titles and abstracts of 2,861 papers were screened. A total of 42 papers were selected for full text reading. Nine papers met the eligibility criteria and were selected for further analysis. Because of the varying graft materials used and the different methods of investigation, as well as the variation in follow-up times, a meta-analysis was not possible. The present review found that clinically, there was a range in loss of width in the control sites of 2.46 mm (SD 0.4 mm) to 4.56 mm (SD 0.33 mm) compared to 1.14 mm (SD 0.87 mm) to 2.5 mm (SD 1.2 mm) in the test sites. The range in loss of height in control sites was 0.9 mm (SD 1.6 mm) to 3.6 mm (SD 1.5 mm) compared to a gain of 1.3 mm (SD 2 mm) to a loss of 0.62 mm (SD 0.51 mm) in test sites. Radiographically a range of change in bone height of between 0.51 mm (No SD) to 1.17 mm (SD 1.23 mm) was noted in control sites compared to a change of between 0.02 mm (SD 1.2 mm) and 1 mm (SD 1.4 mm) in test sites.
There is limited data regarding the effectiveness of alveolar ridge preservation therapies when compared to the control. Overall the socket intervention therapies did reduce alveolar ridge dimensional changes post-extraction, but were unable to prevent resorption. Histology did demonstrate a large proportion of residual graft material that may account for some of the difference in alveolar ridge dimensions at follow up.
评估拔牙后使用移植物和/或屏障膜是否能在尺寸、影像学和/或组织学方面改善拔牙位点的愈合情况。
检索截至2011年8月的MEDLINE、EMBASE以及Cochrane对照试验中心注册库（CENTRAL）。选取纳入并比较了对照组（无干预）与移植物和/或屏障膜组（试验组）拔牙后愈合情况的随机对照试验。
筛选了2861篇论文的标题和摘要。共选出42篇论文进行全文阅读。9篇论文符合纳入标准并被选作进一步分析。由于使用的移植物材料不同、研究方法各异以及随访时间不同，无法进行荟萃分析。本综述发现，临床上，对照组位点宽度丧失范围为2.46毫米（标准差0.4毫米）至4.56毫米（标准差0.33毫米），而试验组位点为1.14毫米（标准差0.87毫米）至2.5毫米（标准差1.2毫米）。对照组位点高度丧失范围为0.9毫米（标准差1.6毫米）至3.6毫米（标准差1.5毫米），而试验组位点高度变化为增加1.3毫米（标准差2毫米）至丧失0.62毫米（标准差0.51毫米）。影像学上，对照组位点骨高度变化范围为0.51毫米（无标准差）至1.17毫米（标准差1.23毫米），而试验组位点变化范围为0.02毫米（标准差1.2毫米）至1毫米（标准差1.4毫米）。
与对照组相比，关于牙槽嵴保存治疗有效性的数据有限。总体而言，拔牙位点干预治疗确实减少了拔牙后牙槽嵴的尺寸变化，但无法防止吸收。组织学显示有很大比例的残余移植物材料，这可能是随访时牙槽嵴尺寸存在差异的部分原因。
