Section of Periodontology, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain.
Facultad de Odontología, Universidad Complutense de Madrid, Plaza Ramón y Cajal, 28040, Madrid, Spain.
Clin Oral Investig. 2018 Apr;22(3):1273-1283. doi: 10.1007/s00784-017-2214-z. Epub 2017 Oct 3.
The objective of this study was to evaluate soft tissue contour changes after three different regenerative therapies in chronic ridge defects.
Buccal bone defects were created in the mandible of nine beagle dogs. Augmentation procedures were performed 3 months later using a bone replacement graft (BRG), resorbable collagen membrane (MBG), or a combination of both procedures (CBG). Silicone impressions were taken before tooth extraction (T1), before the augmentation procedure (T2), and 3 months after the regenerative surgeries (T3). Casts were optically scanned and stereolithography files were superimposed to analyze the horizontal changes in ridge contours.
After defect creation, most part of the horizontal changes occurred 4 and 6 mm below the gingival margin. In the mesial defect (D1) at T3, the mean horizontal gain in MBG amounted to 0.47 ± 0.34 mm, 0.79 ± 0.67 mm in the BRG, and 0.87 ± 0.69 mm for the CBG. In the middle defect (D2), the mean changes for the MBG were 0.11 ± 0.31, 1.01 ± 0.91 for the BRG, and 0.98 ± 0.49 for the CBG. The mean changes in the distal defect (D3) amounted to 0.24 ± 0.72 for the MBG, 1.04 ± 0.92 for the BRG, and 0.86 ± 0.56 for the CBG. The differences reached significance in all defects for the comparison MBG-BRG and MBG-CBG, while similar parameters were observed for the comparison BRG-CBG.
BRG and CBG were equally effective and superior to MBG in increasing the horizontal tissue contours. The augmentation seldom reached the values before extraction.
Scaffolding materials are needed for contour augmentation when using resorbable collagen membranes.
本研究旨在评估三种不同再生疗法在慢性牙槽嵴缺损中的软组织轮廓变化。
在 9 只比格犬的下颌骨中创建颊骨缺损。3 个月后，使用骨替代移植物（BRG）、可吸收胶原膜（MBG）或两者联合（CBG）进行增强程序。在拔牙前（T1）、增强程序前（T2）和再生手术后 3 个月（T3）进行硅橡胶印模。对印模进行光学扫描，并将立体光刻文件叠加，以分析牙槽嵴轮廓的水平变化。
在缺损形成后，大部分水平变化发生在牙龈缘以下 4 和 6mm 处。在 T3 时近中缺损（D1），MBG 的平均水平增加量为 0.47±0.34mm，BRG 为 0.79±0.67mm，CBG 为 0.87±0.69mm。在中间缺损（D2）中，MBG 的平均变化为 0.11±0.31，BRG 为 1.01±0.91，CBG 为 0.98±0.49。远中缺损（D3）的平均变化量为 MBG 为 0.24±0.72，BRG 为 1.04±0.92，CBG 为 0.86±0.56。MBG-BRG 和 MBG-CBG 比较在所有缺损中均达到显著差异，而 BRG-CBG 比较观察到相似的参数。
BRG 和 CBG 在增加水平组织轮廓方面与 MBG 同样有效且优于 MBG。增强很少达到拔牙前的数值。
在使用可吸收胶原膜时，需要支架材料来进行轮廓增强。
