Department of Oral Medicine, Infection and Immunity, HArvard School of Dental Medicine.
Boston Periodontics & Dental Implants, 175 Cambridge Street #310, Boston, Massachusetts 02114.
J Esthet Restor Dent. 2018 May;30(3):180-186. doi: 10.1111/jerd.12357. Epub 2017 Dec 28.
Extraction socket preservation procedures are critical to successful esthetic implant therapy. Conventional surgical approaches are technique sensitive and often result in alteration of the soft tissue architecture, which then requires additional corrective surgical procedures. This case series report presents the ability of flapless surgical techniques combined with a growth factor-enhanced bone matrix to provide esthetic ridge preservation at the time of extraction for compromised sockets.
When considering esthetic dental implant therapy, preservation, or further enhancement of the available tissue support at the time of tooth extraction may provide an improved esthetic outcome with reduced postoperative sequelae and decreased treatment duration. Advances in minimally invasive surgical techniques combined with recombinant growth factor technology offer an alternative for bone reconstruction while maintaining the gingival architecture for enhanced esthetic outcome. The combination of freeze-dried bone allograft (FDBA) and rhPDGF-BB (platelet-derived growth factor-BB) provides a growth-factor enhanced matrix to induce bone and soft tissue healing.
The use of a growth-factor enhanced matrix is an option for minimally invasive ridge preservation procedures for sites with advanced bone loss. Further studies including randomized clinical trials are needed to better understand the extent and limits of these procedures.
The use of minimally invasive techniques with growth factors for esthetic ridge preservation reduces patient morbidity associated with more invasive approaches and increases the predictability for enhanced patient outcomes. By reducing the need for autogenous bone grafts the use of this technology is favorable for patient acceptance and ease of treatment process for esthetic dental implant therapy.
拔牙窝保存术对于成功的美学种植治疗至关重要。传统的手术方法对技术要求较高，往往会导致软组织结构的改变，从而需要额外的矫正手术。本病例系列报告介绍了无瓣手术技术与生长因子增强型骨基质相结合，在受影响的拔牙窝中实现美学牙槽嵴保存的能力。
在考虑美学牙科种植治疗时，在拔牙时保存或进一步增强可用的组织支持，可能会提供更好的美学效果，减少术后后遗症，缩短治疗时间。微创外科技术的进步与重组生长因子技术相结合，为骨重建提供了一种替代方法，同时保持了牙龈结构，以获得更好的美学效果。冻干骨移植物（FDBA）和 rhPDGF-BB（血小板衍生生长因子-BB）的组合提供了一种生长因子增强型基质，可诱导骨和软组织愈合。
生长因子增强型基质的使用是用于有严重骨质流失的部位进行微创牙槽嵴保存的一种选择。需要进一步的研究，包括随机临床试验，以更好地了解这些手术的范围和局限性。
使用生长因子的微创技术进行美学牙槽嵴保存，降低了与更具侵入性方法相关的患者发病率，并提高了增强患者治疗效果的可预测性。通过减少对自体骨移植物的需求，这种技术有利于患者的接受度和美学牙科种植治疗的治疗过程的便利性。
