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即刻种植体植入时在间隙中放置骨替代移植物的效果:一项随机临床试验。

The effect of placing a bone replacement graft in the gap at immediately placed implants: a randomized clinical trial.

机构信息

Faculty of Odontology, University Complutense of Madrid, Madrid, Spain.

Sagralenska Academy, University of Goteborg, Goteborg, Sweden.

出版信息

Clin Oral Implants Res. 2017 Aug;28(8):902-910. doi: 10.1111/clr.12896. Epub 2016 Jun 7.

Abstract

OBJECTIVE

To assess the added value of using a bone replacement graft in combination with immediate implants in reducing the bone dimensional changes occurring in the residual ridge.

MATERIAL AND METHODS

Randomized parallel controlled clinical trial to study the efficacy of grafting with demineralized bovine bone mineral with 10% collagen (DBBM-C) in the gap between the implant surface and the inner bone walls when the implants were immediately placed in the anterior maxilla. The changes between implant placement and 16 weeks later in the horizontal and vertical crestal bone changes in relation to the implant were evaluated through direct bone measurements using a periodontal probe. Mean changes were compared between the experimental and control sites using parametric statistics.

RESULTS

A total of 86 implant sites in 86 subjects were included in the analysis (43 in the test group and 43 in the control group). The horizontal crest dimension underwent marked changes during healing mainly at the buccal aspect of the alveolar crest where this reduction amounted to 1.1 (29%) in the test group and 1.6 mm (38%) in the control group, being these statistically significant (P = 0.02). This outcome was even more pronounced at sites in the anterior maxilla and with thinner buccal bone plates.

CONCLUSIONS

In conclusion, the results from this clinical trial demonstrated that placing a DBBM-C bone replacement graft significantly reduced the horizontal bone resorptive changes occurring in the buccal bone after the immediate implantation in fresh extraction sockets.

摘要

目的

评估使用骨替代移植物与即刻种植体联合应用,减少剩余牙槽嵴骨量发生的三维变化的附加价值。

材料与方法

这是一项随机平行对照临床试验,旨在研究在即刻植入上前部牙槽窝时,在种植体表面与内骨壁之间的间隙中使用含 10%胶原的脱矿牛骨矿物质(DBBM-C)进行移植物的效果。通过牙周探针直接测量骨,评估种植体放置后 16 周时与种植体相关的水平和垂直牙槽嵴顶骨变化。使用参数统计学比较实验组和对照组之间的平均变化。

结果

共有 86 名受试者的 86 个种植体部位纳入分析(实验组 43 个,对照组 43 个)。在愈合过程中,水平牙槽嵴尺寸发生了明显的变化,主要是在牙槽嵴颊侧,实验组减少了 1.1mm(29%),对照组减少了 1.6mm(38%),这在统计学上是显著的(P=0.02)。在前部上颌骨和颊侧骨板较薄的部位,这种结果更为明显。

结论

总之,这项临床试验的结果表明,在新鲜拔牙窝中即刻植入时,使用含 10%胶原的脱矿牛骨矿物质(DBBM-C)骨替代移植物可显著减少颊侧骨的水平骨吸收变化。

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