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评价一种用胶原蛋白膜覆盖的骨替代物在拔牙后用于牙槽嵴保存的效果。一项针对人类的临床和断层随机对照研究。

Evaluation of a bone substitute covered with a collagen membrane for ridge preservation after tooth extraction. Clinical and tomographic randomized controlled study in humans.

机构信息

Departament of Oral & Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.

Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.

出版信息

Clin Oral Implants Res. 2018 Apr;29(4):424-433. doi: 10.1111/clr.13140. Epub 2018 Mar 23.

Abstract

OBJECTIVE

To evaluate the use of a synthetic bone substitute covered with a collagen membrane for ridge preservation after tooth extraction, by clinical and tomographic analysis.

MATERIAL AND METHODS

Fifteen patients, presenting at least two maxillary anterior teeth indicated for extraction, were selected: in the test group (TG), post-extraction sockets were filled by a synthetic bone substitute; in the control group (CG), by blood clot. In both groups, the sockets were covered by a collagen membrane. Cone-beam computerized tomography (CBCT) scans were acquired immediately after and 6 months post-surgically, and horizontal and vertical dimensional bone changes were quantified.

RESULTS

Transurgical clinical analysis presented no statistically significant differences between TG and CG (p > .05). CBCT intragroup evaluation presented statistically significant reduction for the buccal alveolar measurement (TG = 1.58 mm or 21.82%, and CG = 1.66 mm or 24.08%) and horizontal cervical measurement (TG = 0.55 mm or 8.30% and CG = 1.30 mm or 17.68%), and not significant for palatal alveolar measurement (TG = 0.44 mm or 3.42% and CG = 0.26 mm or 3.89%). For alveolar height and horizontal apical measurements, this decrease was significant only for the CG, with reductions of 1.03 mm and 0.50 mm, respectively, compared to a decrease of 0.57 mm and 0.19 mm for the TG. The intergroup analysis showed significant difference for cervical horizontal measurement after 6 months (p < .05).

CONCLUSION

The results showed that the use of the bone substitute covered with a collagen membrane resulted in less changes in vertical and horizontal alveolar ridge dimensions than the collagen membrane alone.

摘要

目的

通过临床和断层分析评估使用覆盖胶原膜的合成骨替代物进行拔牙后牙槽嵴保存的效果。

材料和方法

选择了 15 名至少有两颗上颌前牙需要拔除的患者:在实验组(TG)中,拔牙窝内填充合成骨替代物;在对照组(CG)中,拔牙窝内填充血凝块。两组均用胶原膜覆盖。术后即刻和 6 个月时采集锥形束计算机断层扫描(CBCT),定量测量水平和垂直骨量变化。

结果

术中临床分析显示 TG 和 CG 之间无统计学差异(p>.05)。CBCT 组内评估显示颊侧牙槽测量(TG=1.58mm 或 21.82%,CG=1.66mm 或 24.08%)和水平颈部测量(TG=0.55mm 或 8.30%,CG=1.30mm 或 17.68%)有统计学显著减少,但腭侧牙槽测量(TG=0.44mm 或 3.42%,CG=0.26mm 或 3.89%)无显著减少。对于牙槽骨高度和水平根尖测量,仅 CG 出现显著减少,分别减少 1.03mm 和 0.50mm,而 TG 减少 0.57mm 和 0.19mm。组间分析显示 6 个月时颈部水平测量有显著差异(p<.05)。

结论

结果表明,与单独使用胶原膜相比,使用覆盖胶原膜的骨替代物可使牙槽嵴垂直和水平维度的变化更小。

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