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在不健康拔牙窝中使用同种异体移植物和致密聚四氟乙烯膜并采用开放膜技术进行牙槽嵴保存。

Alveolar Ridge Preservation Using Allografts and Dense Polytetrafluoroethylene Membranes With Open Membrane Technique in Unhealthy Extraction Socket.

作者信息

Cheon Gi-Beom, Kang Kyung Lhi, Yoo Mi-Kyung, Yu Jeoung-A, Lee Dong-Woon

机构信息

1   Department of Periodontology, Veterans Health Service Medical Center, Seoul, Korea.

2   Department of Periodontology, School of Dentistry, Kyung Hee University, Seoul, Korea.

出版信息

J Oral Implantol. 2017 Aug;43(4):267-273. doi: 10.1563/aaid-joi-D-17-00012. Epub 2017 Jun 8.

DOI:10.1563/aaid-joi-D-17-00012
PMID:28594592
Abstract

We evaluated the effectiveness of the open membrane technique using a high-density polytetrafluoroethylene (dPTFE) membrane with freeze-dried bone allografts in damaged sockets for alveolar ridge preservation (ARP). This retrospective study included 26 sites from 20 patients who had received ARP for the placement of dental implants. ARP was conducted using dPTFE membrane with allografts on the day of extraction without primary closure. When the membrane was removed after 4 weeks, the newly formed reddish tissue at the grafted site was checked (first outcome, clinical evaluation). Four months after membrane removal, a core biopsy was performed from the center of the grafted site before implant placement (second outcome, histomorphometric evaluation). Radiographic measurements of alveolar bone changes between implant prosthesis delivery and the 1-year follow-up were obtained (third outcome, radiographic evaluation). A total of 23 sites from 18 patients had no complications during the follow-up period. Three sites from two patients were excluded because of early membrane removal. Newly formed reddish tissue was found at 15 sites, and partially formed tissue was found at 8 sites. Although we were unable to harvest bone core from all sites, histomorphometric analysis in 11 patients indicated that the mean area of new bone was 28.48% ± 6.60%, that of the remaining graft particle was 27.68% ± 9.18%, and that of fibrous tissue was 43.84% ± 6.98%. The mean loss of marginal bone was 0.13 ± 0.06 mm at the mesial area and 0.15 ± 0.06 mm at the distal area, as assessed using radiographic evaluations. The results of this nonrandomized study suggest that this technique may be an appropriate procedure for ARP. Further studies with a control group and more subjectives can be designed based on this study.

摘要

我们评估了使用高密度聚四氟乙烯(dPTFE)膜联合冻干同种异体骨在受损牙槽窝中进行牙槽嵴保存(ARP)的开放膜技术的有效性。这项回顾性研究纳入了20例接受ARP以植入牙种植体的患者的26个位点。在拔牙当天使用dPTFE膜联合同种异体骨进行ARP,不进行一期缝合。4周后取出膜时,检查移植部位新形成的微红组织(第一个结果,临床评估)。取出膜4个月后,在植入种植体前从移植部位中心进行核心活检(第二个结果,组织形态计量学评估)。获得种植修复体交付时与1年随访之间牙槽骨变化的影像学测量结果(第三个结果,影像学评估)。18例患者的23个位点在随访期间无并发症。2例患者的3个位点因早期取出膜而被排除。15个位点发现新形成的微红组织,8个位点发现部分形成的组织。尽管我们无法从所有位点获取骨芯,但对11例患者的组织形态计量学分析表明,新骨的平均面积为28.48%±6.60%,剩余移植颗粒的平均面积为27.68%±9.18%,纤维组织的平均面积为43.84%±6.98%。根据影像学评估,近中区域边缘骨的平均吸收为0.13±0.06mm,远中区域为0.15±0.06mm。这项非随机研究的结果表明,该技术可能是一种适用于ARP的方法。可基于本研究设计有对照组且更多主观指标的进一步研究。

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