Schnutenhaus Sigmar, Doering Isabel, Dreyhaupt Jens, Rudolph Heike, Luthardt Ralph G
Private Practice, Hilzingen, Germany.
Department of Prosthetic Dentistry, Center of Dentistry, Ulm University, Ulm, Germany.
J Periodontal Implant Sci. 2018 Aug 31;48(4):236-250. doi: 10.5051/jpis.2018.48.4.236. eCollection 2018 Aug.
Resorption of the alveolar bone is an unavoidable consequence of tooth extraction when appropriate alveolar ridge preservation (ARP) measures are not taken. The objective of this trial was to test the hypothesis that dimensional changes in the alveolar bone after tooth extraction would be reduced by inserting an equine collagen membrane and a collagen cone to fill and seal the alveolus (as ARP), in comparison to extraction with untreated alveoli.
In this randomized clinical trial, 31 patients were directly treated with the collagen material after extraction of a tooth from the maxilla (the ARP group). Twenty-nine patients served as the control group. After extraction, no further treatment (i.e., no socket preservation measures) was performed in the control group. Changes in the alveolar process immediately after extraction and after an 8 (±1)-week healing period were evaluated 3-dimensionally. Blinded analyses were performed after superimposing the data from the digitalized impressions and surfaces generated by cone-beam computed tomography.
Both the ARP and control groups showed a reduction of bone in the alveolar area after tooth extraction. However, significantly less bone resorption was detected in the clinically relevant buccal region in the ARP group. The median bone reduction was 1.18 mm in the ARP group and 5.06 mm in the control group (=0.03).
The proposed hypothesis that inserting a combination material comprising a collagen cone and membrane would lead to a difference in alveolar bone preservation can be accepted for the clinically relevant buccal distance. In this area, implantation of the collagen material led to significantly less alveolar bone resorption. German Clinical Trials Register at www.drks.de, DRKS00004769.
若未采取适当的牙槽嵴保存(ARP)措施,拔牙后牙槽骨吸收是不可避免的后果。本试验的目的是检验以下假设:与未处理牙槽窝的拔牙相比,拔牙后通过植入马源胶原膜和胶原锥来填充并封闭牙槽窝(作为ARP),可减少牙槽骨的尺寸变化。
在这项随机临床试验中,31例患者在上颌牙拔除后直接接受胶原材料治疗(ARP组)。29例患者作为对照组。拔牙后,对照组未进行进一步治疗(即未采取牙槽窝保存措施)。在拔牙后即刻以及8(±1)周愈合期后,对牙槽突的变化进行三维评估。在对数字化印模数据和锥形束计算机断层扫描生成的表面数据进行叠加后,进行盲法分析。
ARP组和对照组在拔牙后牙槽区域均出现骨量减少。然而,ARP组在临床相关的颊侧区域检测到的骨吸收明显较少。ARP组骨量减少的中位数为1.18 mm,对照组为5.06 mm(P = 0.03)。
对于临床相关的颊侧距离,关于植入包含胶原锥和膜的组合材料会导致牙槽骨保存存在差异的假设可以被接受。在该区域,植入胶原材料导致牙槽骨吸收明显减少。德国临床试验注册库,网址:www.drks.de,DRKS00004769。