Zhao Li-ping, Zhan Ya-lin, Hu Wen-jie, Xu Tao, Wei Yi-ping, Zhen Min, Wang Cui
Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2016 Feb 18;48(1):126-32.
To investigate the changes of the vertical height and width of the alveolar bone six months after the alveolar ridge preservation in periodontal compromised molar sites of severe alveolar bone defects with clinical direct measurement, parallel periapical radiographs, and cone-beam computed tomography (CBCT), and to analyze the effect of the three different methods of measurement.
In this study, 20 subjects requiring tooth extraction on account of periodontal disease with a total of 23 extracted molars were enrolled. Extractions were performed atraumatically and patients were received alveolar ridge preservation procedure with Bio-Oss and Bio-Gide. Clinical direct measurements were taken after tooth extraction and during the implant surgery 6 months later, CBCT scans and parallel periapical radiographs were taken immediately after ridge preservation and 6 months later. The changes of alveolar ridge width and vertical height after six months were measured and analyzed through the above-mentioned three methods and the similarities and differences of the measured effect were compared.
There were no significant difference of alveolar vertical height in the center of the extraction sites, the center of distal aspect, and distobuccal aspect between the clinical direct measurements and the CBCT measurements (P>0.05), alveolar vertical height in other points and alveolar width measurements were statically significant (P<0.05). After 6 months, 10 sites of 10 subjects were received a flap and re-entered to perform dental implants surgery. The vertical height in the center of alveolar increased significantly and the changes of alveolar vertical height of clinical direct and CBCT measurement were (6.15 ± 1.73) mm and (6.59 ± 2.53) mm, respectively. The measurements of the width of the alveolar bone were (8.45 ± 1.18) mm and (8.52 ± 1.27) mm, respectively. The measurements of the two methods were not statistically significant (P>0.05). The change of the alveolar height in the center of the extraction socket after six months measured by parallel periapical was (5.84 ± 4.28) mm, which was closed to the clinical direct measurement and the CBCT measurement.
Clinical direct measurement and CBCT measurement were largely consistent in the evaluation of the alveolar bone height and width after the alveolar ridge preservation using deproteinized boving bone mineral (DBBM, Bio-Oss) and bioabsorbable collagen membrane (Bio-Gide) in periodontal compromised molar sites of severe bone defects.
采用临床直接测量、平行根尖片及锥形束计算机断层扫描(CBCT),研究严重牙槽骨缺损的牙周受损磨牙位点牙槽嵴保存6个月后牙槽骨垂直高度和宽度的变化,并分析三种不同测量方法的效果。
本研究纳入20例因牙周病需要拔牙的受试者,共23颗拔除的磨牙。拔牙过程中尽量减少创伤,患者接受Bio-Oss和Bio-Gide进行牙槽嵴保存术。拔牙后及6个月后种植手术时进行临床直接测量,牙槽嵴保存后即刻及6个月后进行CBCT扫描和平行根尖片拍摄。通过上述三种方法测量并分析6个月后牙槽嵴宽度和垂直高度的变化,比较测量效果的异同。
临床直接测量与CBCT测量在拔牙位点中心、远中面中心及远颊面的牙槽骨垂直高度上无显著差异(P>0.05),其他点的牙槽骨垂直高度及牙槽骨宽度测量差异有统计学意义(P<0.05)。6个月后,10例受试者的10个位点接受翻瓣并再次进入进行牙种植手术。牙槽嵴中心垂直高度显著增加,临床直接测量和CBCT测量的牙槽骨垂直高度变化分别为(6.15±1.73)mm和(6.59±2.53)mm。牙槽骨宽度测量值分别为(8.45±1.18)mm和(8.52±1.27)mm。两种方法测量结果差异无统计学意义(P>0.05)。平行根尖片测量拔牙窝中心6个月后牙槽骨高度变化为(5.84±4.28)mm,与临床直接测量和CBCT测量结果接近。
在严重骨缺损的牙周受损磨牙位点,使用脱蛋白牛骨矿物质(DBBM,Bio-Oss)和生物可吸收胶原膜(Bio-Gide)进行牙槽嵴保存后,临床直接测量和CBCT测量在评估牙槽骨高度和宽度方面基本一致。