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一项使用SocketKAP(™)和SocketKAGE(™)评估牙槽嵴保存与修复的开放性随机对照临床试验:第2部分 - CBCT影像的三维牙槽骨容积分析

An open randomized controlled clinical trial to evaluate ridge preservation and repair using SocketKAP(™) and SocketKAGE(™) : part 2 - three-dimensional alveolar bone volumetric analysis of CBCT imaging.

作者信息

Abdelhamid Alaa, Omran Mostafa, Bakhshalian Neema, Tarnow Dennis, Zadeh Homayoun H

机构信息

Dental Research Center (DRC) and Tissue Engineering and Biomaterials Research Unit (TEBRU), Qassim College of Dentistry, Qassim University, Buraidah, Saudi Arabia.

Laboratory for Immunoregulation and Tissue Engineering (LITE), Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA.

出版信息

Clin Oral Implants Res. 2016 Jun;27(6):631-9. doi: 10.1111/clr.12687. Epub 2015 Oct 31.

Abstract

OBJECTIVES

The aims of this study were (i) to evaluate the efficacy of ridge preservation and repair procedures involving the application of SocketKAP(™) and SocketKAGE(™) devices following tooth removal and (ii) to evaluate alveolar bone volumetric changes at 6 months post-extraction in intact sockets or those with facial wall dehiscence defects using 3-dimensional pre- and postoperative CBCT data.

MATERIALS AND METHODS

Thirty-six patients required 61 teeth extracted. Five cohorts were established: Group A: Intact Socket Negative Control Group B: Intact Socket + SocketKAP(™) Group C: Intact Socket Filled with Anorganic Bovine Bone Mineral (ABBM) + SocketKAP(™) Group D: Facial Dehiscence Socket Negative Control Group E: Facial Dehiscence Socket Filled with ABBM + SocketKAP(™) + SocketKAGE(™) . Preoperative CBCT scans were obtained followed by digital subtraction of the test teeth. At 6 months post-extraction, another CBCT scan was obtained. The pre- and postoperative scans were then superimposed, allowing highly accurate quantitative determination of the 3D volumetric alveolar bone volume changes from baseline through 6 months.

RESULTS

Significant volumetric bone loss occurred in all sockets, localized mainly in the 0-3 mm zone apical to the ridge crest. For intact sockets, SocketKAP(™) + ABBM treatment led to a statistically significant greater percentage of remaining mineralized tissue volume when compared to negative control group. A significant difference favoring SocketKAP(™) + SocketKAGE(™) + ABBM treatment was observed for sockets with facial dehiscence defects compared to the negative control group.

CONCLUSIONS

SocketKAP(™) , with ABBM, appears effective in limiting post-extraction volumetric bone loss in intact sockets, while SocketKAP(™) + SocketKAGE + ABBM appears effective in limiting post-extraction bone loss in sockets with dehiscence defects.

摘要

目的

本研究的目的是:(i)评估拔牙后应用SocketKAP(™)和SocketKAGE(™)装置进行牙槽嵴保存和修复程序的疗效;(ii)使用三维术前和术后CBCT数据评估完整牙槽窝或存在颊侧骨壁裂开缺损的牙槽窝在拔牙后6个月时的牙槽骨体积变化。

材料与方法

36例患者需要拔除61颗牙齿。建立了五个队列:A组:完整牙槽窝阴性对照组;B组:完整牙槽窝 + SocketKAP(™);C组:完整牙槽窝填充无机牛骨矿物质(ABBM)+ SocketKAP(™);D组:颊侧骨壁裂开牙槽窝阴性对照组;E组:颊侧骨壁裂开牙槽窝填充ABBM + SocketKAP(™) + SocketKAGE(™)。术前获得CBCT扫描图像,然后对测试牙齿进行数字减影。拔牙后6个月时,再次进行CBCT扫描。然后将术前和术后扫描图像进行叠加,从而能够高度准确地定量测定从基线到6个月时三维牙槽骨体积的变化。

结果

所有牙槽窝均发生了显著的骨体积丢失,主要集中在牙槽嵴顶下方0 - 3毫米区域。对于完整牙槽窝,与阴性对照组相比,SocketKAP(™) + ABBM治疗导致剩余矿化组织体积的百分比在统计学上显著更高。与阴性对照组相比,对于存在颊侧骨壁裂开缺损的牙槽窝,观察到SocketKAP(™) + SocketKAGE(™) + ABBM治疗具有显著差异。

结论

SocketKAP(™)与ABBM联合使用似乎能有效限制完整牙槽窝拔牙后的骨体积丢失,而SocketKAP(™) + SocketKAGE + ABBM似乎能有效限制存在裂开缺损的牙槽窝拔牙后的骨丢失。

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