Qabbani Ali Al, Razak Noor Hayati A, Kawas Sausan Al, Sheikh Abdul Hamid Suzina, Wahbi Saad, Samsudin A R
*Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah †Sharjah Institute for Medical Research (SIMR), Sharjah, United Arab Emirates ‡School of Dental Sciences Health Campus, Universiti Sains Malaysia, Penang Kubang Kerian, Malaysia.
J Craniofac Surg. 2017 Jun;28(4):e318-e325. doi: 10.1097/SCS.0000000000003569.
The aim of this study was to determine the efficacy of immediate implant placement with alveolar bone augmentation on socket preservation following atraumatic tooth extraction and comparing it with a tooth alveolar socket that was allowed to heal in a conventional way.Twenty medically fit patients (8 males and 12 females aged between 18 and 40 years) who needed noncomplicated tooth extraction of mandibular premolar teeth were divided randomly and equally into 2 groups. In Group I, the empty extraction socket was left untreated and allowed to heal in a conventional way. In Group II, the immediate implant was placed and the gap between the implant and the inner buccal plate surface of the socket wall was filled with lyophilized bovine bone granules and the wound was covered with pericardium membrane. The patients were followed up clinically and radiologically for regular reviews at 1 week, 3 months, and 9 months postoperative. Cone beam computerized tomography images of the alveolar ridge and socket were analyzed to determine the structural changes of the alveolar ridge. Resonance frequency analysis was measured at 9 months for Group II to assess the degree of secondary stability of the implants by using Osstell machine.A significant difference of bone resorption of 1.49 mm (confidence interval, CI 95%, 0.63-2.35) was observed within the control group at 3 months, and 1.84 mm (P ≤ 0.05) at 9 months intervals. No significant changes of bone resorption were observed in Group II. Comparison between groups showed a highly significant difference at 3 months; 2.56 mm (CI 95% 4.22-0.90) and at 9 months intervals; 3.2 mm (CI 95%, 4.70-1.62) P ≤ 0.001 between Group I and II. High resonance frequency analysis values were observed at 9 months postoperative in Group II.In conclusion, the insertion of immediate implants in fresh extraction sockets together with grafting the circumferential gap between the bony socket wall and the implant surface with bovine bone granules was able to preserve a greater amount of alveolar ridge volume when compared with an extraction socket that was left to heal in a conventional way.
本研究的目的是确定在无创伤性拔牙后立即植入种植体并进行牙槽骨增量对牙槽窝保存的效果，并将其与以传统方式愈合的牙齿牙槽窝进行比较。20名身体健康、需要拔除下颌前磨牙且手术不复杂的患者（8名男性和12名女性，年龄在18至40岁之间）被随机平均分为2组。在第一组中，空的拔牙窝未作处理，任其以传统方式愈合。在第二组中，立即植入种植体，种植体与牙槽窝壁内颊板表面之间的间隙用冻干牛骨颗粒填充，伤口用心包膜覆盖。术后1周、3个月和9个月对患者进行临床和影像学随访，定期复查。分析牙槽嵴和牙槽窝的锥形束计算机断层扫描图像，以确定牙槽嵴的结构变化。在9个月时对第二组进行共振频率分析，使用Osstell仪器评估种植体的二级稳定性程度。对照组在3个月时观察到骨吸收有1.49毫米的显著差异（95%置信区间，CI 0.63 - 2.35），在9个月时为1.84毫米（P≤0.05）。第二组未观察到骨吸收的显著变化。组间比较显示，在3个月时差异极显著；2.56毫米（95%CI 4.22 - 0.90），在9个月时差异极显著；第一组和第二组之间为3.2毫米（95%CI，4.70 - 1.62），P≤0.001。在第二组术后9个月观察到高共振频率分析值。总之，与以传统方式愈合的拔牙窝相比，在新鲜拔牙窝中立即植入种植体并同时用牛骨颗粒填充骨牙槽窝壁与种植体表面之间的周向间隙，能够保留更多的牙槽嵴体积。
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