Guarnieri Renzo, Testarelli Luca, Stefanelli Luigi, De Angelis Francesca, Mencio Francesca, Pompa Giorgio, Di Carlo Stefano
Department of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, RomeItaly.
J Oral Maxillofac Res. 2017 Dec 31;8(4):e4. doi: 10.5037/jomr.2017.8404. eCollection 2017 Oct-Dec.
The present paper reports data of a randomized study aimed to analyse and compare the histologic and histomorphometric aspects of bone healing in extraction sites covered with collagen membrane alone or associated with porcine-derived bone graft.
Thirty patients, with single extraction sockets without severe bone wall defects in the premolar/molar region, were included. Ten extraction sockets were grafted with porcine-derived bone and covered with collagen membrane (group 1), 10 sites were covered with collagen membrane alone (group 2), and 10 sites healed spontaneously (group 3). After 4 months of healing, 26 (8 in group 1, 9 in group 2, and 9 in group 3) bone core specimens were harvested for histologic evaluation, then dental implants were placed.
Sites in the group 1 and in the group 2 showed similar histologic and histomorphometric results without significantly differences in the percentage of vital bone (57.43% [SD 4.8] vs. 60.01% [SD 3.2]), and non-mineralized connective tissue 22.99% (SD 5.3) vs. 18.53% (SD 6.2). In group 1 a 16.57% (SD 3.8) of residual material was found.
Results showed that the use of collagen membrane alone or associated to porcine-derived bone improves the healing bone process compared to that of extraction sites spontaneously healed. Moreover, histomorphometric data related to bone quality, indicated that extraction sites without severe walls defects and with a vestibular bone thickness > 1.5 mm, treated with a low resorbtion rate collagen membrane alone, do not need more than 4 months for dental implant insertion.
本文报告一项随机研究的数据，旨在分析和比较仅用胶原膜覆盖或与猪源骨移植联合覆盖的拔牙位点骨愈合的组织学和组织形态计量学方面。
纳入30例患者，其前磨牙/磨牙区有单个拔牙窝且无严重骨壁缺损。10个拔牙窝用猪源骨移植并覆盖胶原膜（第1组），10个位点仅覆盖胶原膜（第2组），10个位点自然愈合（第3组）。愈合4个月后，采集26个（第1组8个、第2组9个、第3组9个）骨芯标本进行组织学评估，然后植入牙种植体。
第1组和第2组的位点显示出相似的组织学和组织形态计量学结果，活骨百分比无显著差异（57.43%[标准差4.8]对60.01%[标准差3.2]），非矿化结缔组织也无显著差异（22.99%[标准差5.3]对18.53%[标准差6.2]）。在第1组中发现16.57%（标准差3.8）的残留材料。
结果表明，与自然愈合的拔牙位点相比，单独使用胶原膜或与猪源骨联合使用可改善骨愈合过程。此外，与骨质量相关的组织形态计量学数据表明，对于无严重骨壁缺损且前庭骨厚度>1.5mm 的拔牙位点，单独使用低吸收率的胶原膜治疗，植入牙种植体不需要超过4个月。
