Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan.
Periodontics, Dental Hospital, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan.
J Periodontol. 2019 Sep;90(9):1014-1022. doi: 10.1002/JPER.18-0574. Epub 2019 Mar 12.
The alveolar ridge undergoes pronounced reduction in height and width following tooth extraction. This study aims to comparatively evaluate the potential for ridge preservation in extraction sockets with buccal bone deficiency of β-tricalcium phosphate coated with poly lactide-co-glycolide (β-TCP/PLGA) and conventional particulate β-TCP.
In six beagles, maxillary first premolars were extracted after removal of their buccal bone plates. Standardized bone defects (4 [mesiodistal width] × 4 [buccopalatal width] × 5 [depth] mm) were created at the sites of extraction sockets and filled with β-TCP/PLGA (test sites) or particulate β-TCP (control sites). Microcomputed tomography, histologic, and histometric evaluations were performed 12 weeks post-surgery.
The test sites exhibited a significantly greater bone volume than the control sites (25.7 ± 2.14 versus 16.0 ± 3.3 mm ), although no statistically significant difference was detected in bone material density (746.3 ± 23.9 versus 714.5 ± 37.0 g/cm , respectively). Relative to the control sites, the test sites exhibited significantly greater alveolar-ridge coronal (2.0 ± 0.4 versus 1.1 ± 0.3 mm) and middle (2.9 ± 0.2 versus 2.1 ± 0.3 mm) horizontal widths and proportions of woven bone (50.3 ± 8.1% versus 38.0 ± 5.2%) and bone marrow (17.7 ± 6.6% versus 9.7 ± 4.1%) but a significantly lower proportion of connective tissue (10.7 ± 4.5% versus 18.3 ± 5.7%).
Within the limitations of this study, the moldable β-TCP/PLGA graft appears to exhibit a greater potential than the conventional particulate β-TCP graft for ridge preservation of extraction sockets with buccal bone deficiency.
拔牙后牙槽嵴高度和宽度明显减小。本研究旨在比较分析颊侧骨缺损的拔牙窝中使用β-磷酸三钙/聚乳酸-共-乙醇酸(β-TCP/PLGA)涂层和传统颗粒状β-TCP 进行牙槽嵴保存的潜力。
在 6 只比格犬中,去除颊侧骨板后拔除上颌第一前磨牙。在拔牙窝部位制备标准化骨缺损(4[近远中宽度]×4[颊腭宽度]×5[深度]mm),并用β-TCP/PLGA(实验组)或颗粒状β-TCP(对照组)填充。术后 12 周进行微计算机断层扫描、组织学和组织计量学评估。
实验组的骨体积明显大于对照组(25.7±2.14mm 比 16.0±3.3mm),但骨材料密度无统计学差异(746.3±23.9g/cm 比 714.5±37.0g/cm )。与对照组相比,实验组牙槽嵴冠向(2.0±0.4mm 比 1.1±0.3mm)和中间(2.9±0.2mm 比 2.1±0.3mm)水平宽度以及编织骨(50.3±8.1%比 38.0±5.2%)和骨髓(17.7±6.6%比 9.7±4.1%)比例明显增加,而结缔组织(10.7±4.5%比 18.3±5.7%)比例明显降低。
在本研究的限制范围内,可塑β-TCP/PLGA 移植物似乎比传统颗粒状β-TCP 移植物更能为颊侧骨缺损的拔牙窝提供更好的牙槽嵴保存效果。