Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.
Division of Oral Surgery, School of Dentistry, Medical University of Vienna, Vienna, Austria.
Clin Oral Implants Res. 2018 Jan;29(1):130-138. doi: 10.1111/clr.13081. Epub 2017 Oct 15.
To assess the timeframe between tooth extraction and radiographically detectable socket cortication in humans.
Two hundred and fifty patients with a CT scan ≤36 months after tooth extraction were included. First, three orthoradial multiplanar reconstruction slices, representing the major part of the extraction socket, were scored regarding the degree of bone healing as (i) healed, that is, complete/continuous cortication of the socket entrance, or (ii) non-healed. Thereafter, based on the results of all three slices, the stage of cortication of the extraction socket, as one unit, was classified as (i) non-corticated, that is, all three slices judged as non-healed, (ii) partially corticated, that is, 1 or 2 slices judged as non-healed, or (iii) completely corticated, that is, all three slices judged as healed. The possible effect of several independent parameters, that is, age, gender, timeframe between tooth extraction and CT scan, tooth type, extent of radiographic bone loss of the extracted tooth, tooth-gap type, smoking status, presence of any systemic disease, and medication intake, on cortication status was statistically evaluated.
Three to 6 months after tooth extraction, 27% of the sockets were judged as non-corticated and 53% were judged as partially corticated. After 9-12 months, >80% of the sockets were corticated, while some incompletely corticated sockets were detected up to 15 months after extraction. Each additional month after tooth extraction contributed significantly to a higher likelihood of a more advanced stage of cortication, while radiographic bone loss ≥75% significantly prolonged cortication time; no other independent variable had a significant effect.
The results indicate a considerably long timeframe until complete cortication of an extraction socket, that is, 3-6 months after tooth extraction 3 of 4 sockets were still not completely corticated, and only after 9-12 months, complete cortication was observed in about 80% of the sockets.
评估人类拔牙后至牙槽骨皮质可见的时间框架。
共纳入 250 例拔牙后 CT 扫描时间≤36 个月的患者。首先，对代表拔牙窝主要部分的三个正交多平面重建切片，根据骨愈合程度进行评分，分为（i）愈合，即牙槽窝入口完全/连续皮质化，或（ii）未愈合。此后，根据所有三个切片的结果，将拔牙窝皮质化的阶段作为一个单位进行分类，分为（i）未皮质化，即所有三个切片均判断为未愈合，（ii）部分皮质化，即 1 或 2 个切片判断为未愈合，或（iii）完全皮质化，即所有三个切片均判断为愈合。统计学评估了年龄、性别、拔牙与 CT 扫描之间的时间间隔、牙齿类型、拔牙牙的影像学骨丧失程度、牙间隙类型、吸烟状况、任何系统性疾病的存在以及药物摄入等几个独立参数对皮质化状态的可能影响。
拔牙后 3 至 6 个月，27%的牙槽窝被判断为未皮质化，53%的牙槽窝被判断为部分皮质化。9-12 个月后，超过 80%的牙槽窝皮质化，但在拔牙后 15 个月仍检测到一些不完全皮质化的牙槽窝。拔牙后每个额外的月都会显著增加皮质化阶段更高级别的可能性，而影像学骨丧失≥75%则显著延长皮质化时间；其他独立变量没有显著影响。
结果表明，拔牙后完全皮质化的时间框架相当长，即拔牙后 3-6 个月，4 个牙槽窝中有 3 个仍未完全皮质化，只有在 9-12 个月后，约 80%的牙槽窝才观察到完全皮质化。
