Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Medicine and Surgery, University of Naples "Federico II", Via S. Pansini 5, 80100 Naples, Italy.
Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", Doctorate School in Traslational and Clinical Medicine, University of Salerno, Via S. Allende, 84081 Baronissi (Salerno), Italy.
Clin Implant Dent Relat Res. 2017 Dec;19(6):1044-1053. doi: 10.1111/cid.12537. Epub 2017 Sep 14.
Alveolar ridge volume loss may be minimized when postextraction sockets are filled by bone substitutes.
The aim of the study was to measure the effect of alveolar ridge preservation (ARP) in maintaining the external contour of the ridge after fresh socket grafting with or without particulate anorganic bovine bone mineral (BBM) and resorbable barrier covering.
In the present controlled study, patients subjected to single-tooth extraction were allocated to 2 groups: postextraction sockets grafted with bovine bone mineral (bbm), and naturally healing sockets (nat). Before and at 5 months following tooth extraction, plaster cast contours of the sockets were acquired by means of an optical scanner; the 2 contours of each patient underwent voxelization and fusion using a matrix elaborator. Outcome variables at 5 months (volumetric, surface, and linear changes) were measured in digital fused plaster casts with a dental scan software analyzing a volume of interest ranging from residual papilla to 10 mm toward the apical point. Intra- and inter-group pair-wise variables' comparisons were conducted. Level of significance was set at 0.05.
Twenty-four sites were enrolled: 12 ARP and 12 naturally healed. Five-month percentage of volume loss of the bbm-group (21.7% ± 7.4%) was significantly lower (Ps < .0003) than that of the naturally healing group (38.8% ± 7.9%). When tooth position was investigated, volume loss in percentage registered a significantly better (P values ≤ .0485) behavior in molars (ΔV% = -19.1% ± 6.5% and ΔV% = -35.6% ± 7.6%, respectively, for bbm and nat) than that in premolars (ΔV% = -26.9% ± 7.2% and ΔV% = -45.1% ± 4.2%, respectively, for bbm and nat), in both the preserved and naturally healing groups.
The dimensional loss in postextraction sockets grafted with anorganic bovine bone substitute and covered by a resorbable collagen barrier was lower than that of the naturally healing sites. However, ridge preservation was able to maintain almost 80% of the pristine bone.
在拔牙后牙槽窝中填充骨替代物可以最大程度地减少牙槽嵴容积的丧失。
本研究的目的是测量牙槽嵴保存(ARP)在新鲜牙槽窝植骨后,是否可以维持牙槽嵴的外形,无论是否使用颗粒状无机牛骨矿物质(BBM)和可吸收屏障覆盖。
在本对照研究中,将接受单颗牙齿拔除的患者分为两组:一组为骨矿物质(bbm)组,另一组为自然愈合组(nat)。在拔牙前和拔牙后 5 个月,使用光学扫描仪获取牙槽窝的石膏模型轮廓;使用矩阵编辑软件对每个患者的两个轮廓进行体素化和融合。在数字化融合石膏模型上,使用牙扫描软件测量 5 个月时的体积、表面和线性变化(在从残余乳头到根尖方向 10mm 的感兴趣区域内进行测量)。对组内和组间的变量进行两两比较。显著性水平设为 0.05。
共纳入 24 个位点:12 个 ARP 位点和 12 个自然愈合位点。bbm 组 5 个月时的体积损失百分比(21.7%±7.4%)明显低于自然愈合组(38.8%±7.9%)(P<.0003)。当研究牙齿位置时,磨牙的体积损失百分比表现出更好的结果(P 值均<.0485),bbm 组和 nat 组分别为-19.1%±6.5%和-35.6%±7.6%,而前磨牙的体积损失百分比则分别为-26.9%±7.2%和-45.1%±4.2%,bbm 组和 nat 组均如此。
在无机牛骨替代物和可吸收胶原屏障覆盖的拔牙后牙槽窝中,体积丢失小于自然愈合部位。然而,牙槽嵴保存可以维持近 80%的原始骨量。