Sabet Javad Mehrani, Amoian Babak, Seyedmajidi Maryam
Department of Periodontics, School of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran.
Department of Periodontics, School of Dentistry, Babol University of Medical Sciences, Babol, Iran.
Dent Res J (Isfahan). 2017 Mar-Apr;14(2):97-103.
Following loss of teeth, atrophy of alveolar ridge of the jaws is a substantial problem and unintended outcome that compels clinicians to perform bone reconstruction ahead of implant placement. Although autogenous bone is recommended as the gold standard in bone reconstruction, aninvasive second surgery harvestinga limited volume of bone (from intraoral source) has led a significant approachingthe use of synthetic bone substitute materials. The aim of this study was to evaluate the histologic and histomorphometric properties of porous titanium granules (Natix) used in horizontal reconstruction of alveolar ridge before implant placement.
In the present quasi-experimental clinical trial, four patients (three females and one male) needed horizontal bone augmentation on ten areas of edentulous mandibular ridge before implant treatment. During surgery, the buccal aspect of edentulous ridge was augmented by Natix, covered by resorbable membrane (Cytoplast). After 8 months, 10 core biopsies were obtained.
In histological study, no foreign body reaction at the site of the newly formed bone or around the biomaterial residue was observed. Newly formed bone was fully vital with large lacunae containing osteocytes. In 60% of cases, connective tissue was observed at the biomaterial - new bone interface. In histomorphometric study, mean percentage of bone formation was 40.56% ± 19.83% and mean bone trabecular thickness was 39.98 ± 17.54 μ.
Despite acceptable histological and histomorphometric bone formation findings, in clinical terms, no increase was created in the horizontal dimension. Thus, it seems that application of this biomaterial in horizontal reconstruction of alveolar ridges with noncontained defects is inappropriate.
牙齿缺失后,颌骨牙槽嵴萎缩是一个严重问题且是意外后果,这迫使临床医生在植入种植体之前进行骨重建。尽管自体骨被推荐为骨重建的金标准,但侵入性的二次手术获取有限体积的骨(来自口腔内)已促使大量人开始使用合成骨替代材料。本研究的目的是评估在植入种植体前用于牙槽嵴水平重建的多孔钛颗粒(Natix)的组织学和组织形态计量学特性。
在本准实验性临床试验中,四名患者(三名女性和一名男性)在种植治疗前需要对无牙下颌牙槽嵴的十个区域进行水平骨增量。手术过程中,用Natix对无牙牙槽嵴的颊侧进行增量,并用可吸收膜(Cytoplast)覆盖。8个月后,获取了10个核心活检样本。
在组织学研究中,在新形成骨的部位或生物材料残留物周围未观察到异物反应。新形成的骨完全有活力,有大的含骨细胞的腔隙。在60%的病例中,在生物材料 - 新骨界面观察到结缔组织。在组织形态计量学研究中,骨形成的平均百分比为40.56%±19.83%,平均骨小梁厚度为39.98±17.54μm。
尽管在组织学和组织形态计量学骨形成方面有可接受的结果,但从临床角度来看,水平维度没有增加。因此,似乎这种生物材料在无包容缺损的牙槽嵴水平重建中的应用是不合适的。