Salivary Gland Disease Center and Molecular Laboratory for Gene Therapy and Tooth Regeneration, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing, China.
Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing, China.
Clin Oral Implants Res. 2017 Nov;28(11):e252-e261. doi: 10.1111/clr.13010. Epub 2017 Apr 19.
This study sought to investigate the histological changes following tooth extraction, ridge preservation and augmentation, using novel devices designed to obturate the oral orifice of extraction sockets (SocketKAP™) and provide structural support for sockets with defective bony walls (SocketKAGE™) in a non-human primate model.
Six Macaca fascicularis were imaged by cone beam computed tomography to register their preoperative alveolar bone. Three teeth were extracted in each animal, yielding intact socket walls and were divided into three intervention groups: unassisted healing negative control (Group A); SocketKAP™ (Group B); filled with anorganic bovine bone mineral (ABBM) + SocketKAP™ (Group C). Three additional teeth were extracted in each animal, followed by surgical resection of the entire buccal alveolar bone and divided into three groups: negative control (Group D); SocketKAP™ + SocketKAGE™ (Group E); ABBM + SocketKAP™ + SocketKAGE™ (Group F). Animals were euthanized after 12 weeks, and treatment sites were examined by histology and histomorphometric analysis.
Control sockets with unassisted healing (Groups A and D) underwent severe loss of bone width, height and total area (approximately 40-60% loss). Application of SocketKAP™ in sites with intact walls, as well as SocketKAP™ plus SocketKAGE™ in sites with defective buccal walls lead to higher preservation of alveolar bone height after 12 weeks post-intervention. Addition of ABBM leads to the highest degree of alveolar bone dimensional preservation. Control sites with unassisted healing (Groups A and D), as well as sites treated with extraction socket devices (Groups B and E) without ABBM yielded higher percentage of vital bone, compared with sites filled with ABBM (Groups C and F). No adverse histological responses were noted to SocketKAP™ or SocketKAGE™ devices.
SocketKAP™ + SocketKAGE™ devices proved effective in reducing post-extraction alveolar bone resorption mediating favorable wound healing within sockets. Addition of ABBM was associated with reduced volumetric loss, although the bone fill was characterized by less mature as well as more woven bone.
本研究旨在通过一种新型的牙种植体,即牙槽窝封闭器(SocketKAP)和牙槽骨修复器(SocketKAGE),观察拔牙后、牙槽嵴保存和修复的组织学变化,该新型牙种植体设计用于封闭拔牙窝的口腔开口,并为具有缺陷骨壁的牙槽窝提供结构支撑。
使用锥形束 CT 对 6 只食蟹猴进行成像,以记录其术前牙槽骨情况。在每只动物的 3 颗牙齿中进行拔牙,保留完整的牙槽窝壁,并将其分为 3 个干预组:无辅助愈合阴性对照组(A 组);SocketKAP(B 组);用无机牛骨矿物质(ABBM)填充+SocketKAP(C 组)。在每只动物的另外 3 颗牙齿中进行拔牙,然后切除整个颊牙槽骨,并分为 3 组:阴性对照组(D 组);SocketKAP+SocketKAGE(E 组);ABBM+SocketKAP+SocketKAGE(F 组)。动物在 12 周后被安乐死,通过组织学和组织形态计量学分析检查治疗部位。
无辅助愈合的对照拔牙窝(A 组和 D 组)牙槽骨宽度、高度和总面积严重丧失(约 40-60%丧失)。在完整牙槽窝壁上应用 SocketKAP,以及在颊侧牙槽骨有缺陷的部位应用 SocketKAP+SocketKAGE,在干预后 12 周时可更高地保留牙槽骨高度。添加 ABBM 可实现牙槽骨尺寸的最大程度保留。无辅助愈合的对照拔牙窝(A 组和 D 组)以及未添加 ABBM 的拔牙窝治疗装置(B 组和 E 组)的活骨百分比高于添加 ABBM 的拔牙窝(C 组和 F 组)。未发现 SocketKAP 或 SocketKAGE 装置有任何不良的组织学反应。
SocketKAP+SocketKAGE 装置可有效减少拔牙后牙槽骨吸收,促进拔牙窝内伤口愈合。添加 ABBM 与减少体积损失有关,但骨填充表现为更不成熟和更多编织骨。