Shalash Mahmoud A, Rahman Hatem A, Azim Amr A, Neemat Amani H, Hawary Hesham E, Nasry Sherine A
Researcher, Department of Oral Surgery & Medicine, National Research Center, Giza, Egypt.
Professor, Department of Oral & Maxillofacial Surgery, Faculty of Oral and Dental medicine, Cairo, Egypt.
J Clin Exp Dent. 2013 Dec 1;5(5):e253-9. doi: 10.4317/jced.51244.
To evaluate the effectiveness of beta tricalcium phosphate (β-TCP) alone compared to β-TCP and Demineralized Bone Matrix (DBM) in regenerating localized horizontal maxillary alveolar ridge deficiencies prior to implant placement.
The study included 20 patients with horizontal maxillary ridge deficiencies limited to one or more neighbouring teeth and initial ridge width of ≤ 5mmm. Patients were divided equally into two equal groups. Ridge augmentation was performed using Guided Bone Regeneration (GBR) principals. In group I GBR was performed using β-TCP only, while in group II both β-TCP and DBM were used. Following a 6 months healing period, bone cores from both groups were retrieved and implants were inserted. Specimens were examined histologically to calculate percentage of mineralized bone. Apical and crestal changes in ridge dimensions were calculated by digital subtraction using Cone Beam Computed Tomography (CBCT) immediately after graft placement and six months later.
There was a statistically significant difference between the mean area percentage of mineralized bone between both groups where it was 40.1 % (range: 27.76-% 66.29 %) for group I and 68.96 % (range: 60.07 % - 87.33 %) for group II. Radiograpically, the mean ridge width in group I increased crestally to 4.66 mm (range:3.5-5mm) and apically to 6.12 mm (range: 4.1-6.7 mm). In group II the mean ridge width increased crestally to 5.2 mm (range 4.9-5.4mm) and apically to 6.9 mm (range 6.0-7.8 mm). Group II showed more bone gain with a mean of 1.37 mm crestally and 2.44 mm apically. This difference however was not statistically significant Conclusion: Within the limitations of this study the combination of DBM and β-TCP can be used effectively in cases exhibiting minimal alveolar ridge defects. Key words:Guided bone regeneration, equine bone, alloplast, bone graft.
评估单纯使用β-磷酸三钙(β-TCP)与使用β-TCP和脱矿骨基质(DBM)在种植体植入前对上颌局限性水平牙槽嵴缺损进行再生的有效性。
该研究纳入了20例上颌水平嵴缺损仅限于一个或多个相邻牙齿且初始嵴宽度≤5mm的患者。患者被平均分为两组。使用引导骨再生(GBR)原则进行嵴增高术。在第一组中,仅使用β-TCP进行GBR,而在第二组中,同时使用β-TCP和DBM。经过6个月的愈合期后,从两组中获取骨芯并植入种植体。对标本进行组织学检查以计算矿化骨的百分比。使用锥形束计算机断层扫描(CBCT)在植骨后立即以及6个月后通过数字减法计算嵴尺寸的根尖和嵴顶变化。
两组之间矿化骨的平均面积百分比存在统计学显著差异,第一组为40.1%(范围:27.76%-66.29%),第二组为68.96%(范围:60.07%-87.33%)。影像学上,第一组的平均嵴宽度在嵴顶增加到4.66mm(范围:3.5-5mm),在根尖增加到6.12mm(范围:4.1-6.7mm)。在第二组中,平均嵴宽度在嵴顶增加到5.2mm(范围4.9-5.4mm),在根尖增加到6.9mm(范围6.0-7.8mm)。第二组显示出更多的骨增量,平均在嵴顶为1.37mm,在根尖为2.44mm。然而,这种差异没有统计学显著性。结论:在本研究的局限性内,DBM和β-TCP的组合可有效地用于牙槽嵴缺损最小的病例。关键词:引导骨再生、马骨、异体植入物、骨移植。