Choi Ho-Keun, Cho Hag-Yeon, Lee Sung-Jo, Cho In-Woo, Shin Hyun-Seung, Koo Ki-Tae, Lim Hyun-Chang, Park Jung-Chul
Department of Periodontology, Dankook University College of Dentistry, Cheonan, Korea.
Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea.
J Periodontal Implant Sci. 2017 Dec;47(6):372-380. doi: 10.5051/jpis.2017.47.6.372. Epub 2017 Dec 31.
The aim of this prospective pilot study was to compare alveolar ridge preservation (ARP) procedures with open-healing approach using a single-layer and a double-layer coverage with collagen membranes using radiographic and clinical analyses.
Eleven molars from 9 healthy patients requiring extraction of the maxillary or mandibular posterior teeth were included and allocated into 2 groups. After tooth extraction, deproteinized bovine bone mineral mixed with 10% collagen was grafted into the socket and covered either with a double-layer of resorbable non-cross-linked collagen membranes (DL group, n=6) or with a single-layer (SL group, n=5). Primary closure was not obtained. Cone-beam computed tomography images were taken immediately after the ARP procedure and after a healing period of 4 months before implant placement. Radiographic measurements were made of the width and height changes of the alveolar ridge.
All sites healed without any complications, and dental implants were placed at all operated sites with acceptable initial stability. The measurements showed that the reductions in width at the level 1 mm apical from the alveolar crest (including the bone graft) were -1.7±0.5 mm in the SL group and -1.8±0.4 mm in the DL group, and the horizontal changes in the other areas were also similar in the DL and SL groups. The reductions in height were also comparable between groups.
Within the limitations of this study, single-layer and double-layer coverage with collagen membranes after ARP failed to show substantial differences in the preservation of horizontal or vertical dimensions or in clinical healing. Thus, both approaches seem to be suitable for open-healing ridge preservation procedures.
本前瞻性试点研究的目的是通过影像学和临床分析,比较采用单层和双层胶原膜覆盖的开放愈合方法进行牙槽嵴保存(ARP)的效果。
纳入9例需要拔除上颌或下颌后牙的健康患者的11颗磨牙,并分为2组。拔牙后,将与10%胶原混合的脱蛋白牛骨矿物质植入牙槽窝,并用双层可吸收非交联胶原膜覆盖(DL组,n = 6)或单层覆盖(SL组,n = 5)。未进行一期缝合。在ARP手术后以及种植体植入前4个月的愈合期后,立即拍摄锥形束计算机断层扫描图像。对牙槽嵴的宽度和高度变化进行影像学测量。
所有部位均愈合良好,无任何并发症,所有手术部位均植入了具有可接受初始稳定性的牙种植体。测量结果显示,在距牙槽嵴顶1 mm处(包括骨移植部位),SL组的宽度减少量为-1.7±0.5 mm,DL组为-1.8±0.4 mm,DL组和SL组其他区域的水平变化也相似。两组之间的高度减少量也相当。
在本研究的局限性范围内,ARP术后采用单层和双层胶原膜覆盖在水平或垂直尺寸的保存或临床愈合方面未显示出实质性差异。因此,这两种方法似乎都适用于开放愈合的牙槽嵴保存手术。