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三种不同牙槽嵴保存技术的有效性:一项初步随机对照试验

Effectiveness of three different alveolar ridge preservation techniques: a pilot randomized controlled trial.

作者信息

Avila-Ortiz Gustavo, Rodriguez Juan Carlos, Rudek Ivan, Benavides Erika, Rios Hector, Wang Hom-Lay

出版信息

Int J Periodontics Restorative Dent. 2014 Jul-Aug;34(4):509-21. doi: 10.11607/prd.1838.

Abstract

The aim of this pilot study was to obtain preliminary data regarding the effectiveness of three different alveolar ridge preservation modalities as compared with a control. Subjects in need of single-rooted tooth extraction were recruited and randomly allocated to one of four treatment groups: group 1 (control)--collagen plug; group 2--socket grafting and polytetrafluoroethylene (PTFE) barrier; group 3--socket grafting, buccal overbuilding, and PTFE barrier; group 4--socket grafting, collagen barrier, and PTFE barrier. The grafting material used in all groups was an allograft. At 16 weeks, surgical reentry was performed, and a bone core biopsy was harvested for histomorphometric analysis. A cone beam computed tomography scan was obtained at baseline and before surgical reentry. Clinical (keratinized mucosa [KM] and buccolingual ridge width [RW] changes) and volumetric outcomes were statistically analyzed. A total of 20 patients were recruited (5 patients per group). KM and buccolingual RW changes were minimal during the 16-week healing period for all groups, with no statistically significant differences. Volumetric analyses revealed comparable alveolar ridge resorption values for groups 1, 2, and 4 (3%, 7%, and 5%, respectively), while group 3 exhibited more reduction (16%). Histomorphometric analysis revealed the presence of adequate average values of mineralized tissue (group 1, 46.4%; group 2, 28.88%; group 3, 48.81%; group 4, 41.13%). Based on the clinical and volumetric outcomes, none of the ridge preservation modalities was superior to the control. The combination allograft (freeze-dried bone allograft and demineralized freeze-dried bone allograft) employed in this study appears to be a safe and adequate biomaterial for intraoral grafting.

摘要

本初步研究的目的是获取与对照组相比,三种不同牙槽嵴保存方式有效性的初步数据。招募需要拔除单根牙的受试者,并将其随机分配到四个治疗组之一:第1组(对照组)——胶原塞;第2组——牙槽窝植骨及聚四氟乙烯(PTFE)屏障膜;第3组——牙槽窝植骨、颊侧加高及PTFE屏障膜;第4组——牙槽窝植骨、胶原屏障膜及PTFE屏障膜。所有组使用的植骨材料均为同种异体骨。在16周时,进行再次手术入路,并采集骨芯活检标本进行组织形态计量学分析。在基线和再次手术入路前进行锥形束计算机断层扫描。对临床指标(角化黏膜[KM]和颊舌向牙槽嵴宽度[RW]变化)和体积测量结果进行统计学分析。共招募了20名患者(每组5名)。所有组在16周愈合期内KM和颊舌向RW变化均最小,无统计学显著差异。体积分析显示,第1组、第2组和第4组的牙槽嵴吸收值相当(分别为3%、7%和5%),而第3组吸收更多(16%)。组织形态计量学分析显示矿化组织平均值充足(第1组为46.4%;第2组为28.88%;第3组为48.81%;第4组为41.13%)。基于临床和体积测量结果,没有一种牙槽嵴保存方式优于对照组。本研究中使用的复合同种异体骨(冻干同种异体骨和脱矿冻干同种异体骨)似乎是一种安全且合适的口腔内植骨生物材料。

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