Sbordone Carolina, Toti Paolo, Martuscelli Ranieri, Guidetti Franco, Ramaglia Luca, Sbordone Ludovico
Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Medicine and Surgery, University of Naples "Federico II", Naples, Italy.
Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy.
Clin Oral Implants Res. 2016 Sep;27(9):1152-9. doi: 10.1111/clr.12712. Epub 2015 Oct 5.
The aim of the study was to analyze volume changes of post-extractive sockets grafted with or without deproteinized bovine bone mineral (DBBM) and a resorbable barrier.
This retrospective analysis utilized patients who had undergone tooth extraction. Sites, one per patient, were allocated to two groups: post-extractive non-grafted sockets (NG) and post-extractive grafted sockets with DBBM and resorbable barrier insertion (G). Maximal primary soft tissue closure was sought for both procedures. Before extraction and 6 months later, three-dimensional features of the sockets (linear indexes, areas, and volumes) and outcome variables at 6 months (volume- and surface changes) were acquired through computer tomography scans. Intra- and inter-group comparisons of the outcome variables were performed. Nonparametric tests were applied with a level of significance set at P < 0.01.
Twenty-four sites, 9 grafted and 15 ungrafted, were enrolled. Between baseline and the 6-month evaluation, significant bone volume loss, superior surface shrinkage, and height reduction were registered for the G (72 mm(3) , 76 mm(2) , and 0.5 mm, respectively) and the NG group (274 mm(3) , 87 mm(2) , and 1.8 mm, respectively) with all P-values ≤ 0.0039. A significant difference, regarding the percentage of the volume change, was registered between the two procedures with a volume loss of 9.9% for the grafted sockets and 34.8% for the ungrafted ones (P-value = 0.0073).
Grafting of the sockets with DBBM and a resorbable barrier insertion seemed to reduce negative osseous remodeling in the short term when compared to that of the ungrafted sockets.
本研究旨在分析使用或未使用脱蛋白牛骨矿物质（DBBM）及可吸收屏障进行移植的拔牙后牙槽窝的容积变化。
本回顾性分析纳入了接受拔牙的患者。每位患者选取一个部位，分为两组：拔牙后未移植的牙槽窝（NG组）和拔牙后植入DBBM并插入可吸收屏障的移植牙槽窝（G组）。两种手术均力求实现最大程度的初期软组织闭合。在拔牙前及6个月后，通过计算机断层扫描获取牙槽窝的三维特征（线性指标、面积和容积）以及6个月时的结局变量（容积和表面变化）。对结局变量进行组内和组间比较。采用非参数检验，显著性水平设定为P < 0.01。
共纳入24个部位，其中9个为移植部位，15个为未移植部位。在基线至6个月评估期间，G组（分别为72 mm³、76 mm²和0.5 mm）和NG组（分别为274 mm³、87 mm²和1.8 mm）均出现了显著的骨体积丢失、上颌表面收缩和高度降低，所有P值均≤0.0039。两种手术在容积变化百分比方面存在显著差异，移植牙槽窝的容积损失为9.9%，未移植牙槽窝的容积损失为34.8%（P值 = 0.0073）。
与未移植的牙槽窝相比，植入DBBM并插入可吸收屏障似乎在短期内减少了牙槽骨的负面重塑。
