Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Republic of Korea.
Department of Applied Life Science, BK21 PLUS Project, College of Dentistry, Seoul, Republic of Korea.
Clin Implant Dent Relat Res. 2018 Oct;20(5):729-737. doi: 10.1111/cid.12628. Epub 2018 Jul 27.
Clinical benefits in bone grafting of intact extraction socket have been widely known, but limited evidence is available for the procedure in damaged extraction sockets due to periodontal disease.
This study aimed to determine the dimensional alteration of alveolar ridge following bone grafting of damaged extraction sockets, and compare the outcomes of using deproteinized bovine (DBBM) versus porcine bone mineral (DPBM) in the damaged sockets.
One hundred patients (n = 50 for each group) with periodontitis-induced damaged extraction socket were included in this randomized, single-blind trial. After removal of tooth and granulation tissue, sites were grafted with either DBBM (DBBM group) or DPBM (DPBM group), and covered with collagen membrane. Linear/volumetric analyses of hard and soft-tissue dimensions were performed on reconstructed/superimposed computed tomography and scanned cast images, taken immediately and 4 months after surgery.
The two groups showed comparable hard tissue augmentation with minimal reductions in the grafted volume, as well as in vertical (1.22 ± 2.16 and 1.45 ± 1.92 mm for DPBM and DBBM group, respectively) and horizontal (1.43 ± 3.40 and 1.83 ± 2.85 mm on the central section, respectively) dimensions at 4 months after surgery. However, several cases showed large variations in maintenance of the grafted volume. None of the measured parameters in hard and soft tissue dimensions differed significantly between DBBM and DPBM sites.
DBBM and DPBM can comparably augment damaged extraction sockets with minimal postoperative reduction of the grafted volume. However, the large variations in the results should be further evaluated for application in routine dental clinics.
完整拔牙窝植骨的临床益处已被广泛知晓,但由于牙周病导致的拔牙窝受损,该方法的相关证据有限。
本研究旨在确定受损拔牙窝植骨后牙槽嵴的尺寸变化,并比较使用脱蛋白牛骨(DBBM)和猪骨矿物质(DPBM)在受损窝内的效果。
本随机、单盲试验纳入了 100 名(每组 50 名)患有牙周病导致的受损拔牙窝的患者。拔牙和肉芽组织去除后,使用 DBBM(DBBM 组)或 DPBM(DPBM 组)进行植骨,并覆盖胶原膜。术后即刻和 4 个月时,通过重建/叠加计算机断层扫描和扫描模型图像,对硬组织和软组织的线性/体积进行分析。
两组在硬组织方面均有类似的增量,移植体积仅略有减少,且在术后 4 个月时,在垂直方向(DPBM 和 DBBM 组分别为 1.22±2.16 和 1.45±1.92 mm)和水平方向(中央截面分别为 1.43±3.40 和 1.83±2.85 mm)上的尺寸也相似。然而,有几个病例显示移植体积的维持存在较大差异。硬组织和软组织各参数在 DBBM 和 DPBM 之间无显著差异。
DBBM 和 DPBM 均可对受损拔牙窝进行类似的增量,且术后移植体积的减少可忽略不计。然而,对于在常规牙科诊所的应用,还需要进一步评估这些结果的变异性。