Taschieri Silvio, Del Fabbro Massimo, Panda Sourav, Goker Funda, Babina Ksenia S, Tampieri Anna, Mortellaro Carmen
Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano.
Dental Clinic, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
J Craniofac Surg. 2019 Jun;30(4):1089-1094. doi: 10.1097/SCS.0000000000005416.
This prospective study is aimed at investigating clinically and histologically the effectiveness of a biomimetic magnesium-enriched-hydroxyapatite (MgHA)/collagen-based bone substitute for alveolar socket preservation.
Patients scheduled for posterior single tooth extraction were included. The alveolar socket was filled either with MgHA or deproteinized bovine bone matrix (DBBM). In DBBM group, a punch of mucosa was taken from the palate and used to cover the graft. Vertical and horizontal dimensional changes of the alveolar process were assessed clinically with a periodontal probe and with 3-dimensional (3D) analysis of a cast model. Postoperative quality of life was assessed through a questionnaire. After 6 months of healing, an alveolar tissue biopsy was taken for histologic and histomorphometric analysis of the newly formed tissue. After checking normality of the distributions, parametric or nonparametric tests were used for statistical comparisons.
Twenty patients (12 males, 8 females, mean age 42.8 ± 5.1 years, range 33-50 years) were treated. After 6 months, vertical and horizontal alveolar ridge resorption was similar in the 2 groups. The 3D analysis of the models showed a significantly higher resorption at the buccal side than at the palatal/lingual side. Histomorphometric analysis showed similar new bone formation for MgHA group (23.07 ± 10.3%) and DBBM (22.77 ± 6.95%), and a significantly higher residual material% for DBBM (15.77 ± 1.95%) than MgHA (5.01 ± 1.04%). Significantly less pain was reported in the first 3 days after surgery in patients of the MgHA group.
The MgHA was as safe and effective as DBBM and may represent a feasible bone substitute for alveolar socket preservation.
本前瞻性研究旨在从临床和组织学方面调查一种仿生富镁羟基磷灰石（MgHA）/胶原蛋白基骨替代物用于牙槽窝保存的有效性。
纳入计划拔除后牙单颗牙的患者。牙槽窝分别用MgHA或脱蛋白牛骨基质（DBBM）填充。在DBBM组，从腭部取一块黏膜用于覆盖移植物。使用牙周探针临床评估牙槽突的垂直和水平尺寸变化，并对模型进行三维（3D）分析。通过问卷调查评估术后生活质量。愈合6个月后，取牙槽组织活检进行新形成组织的组织学和组织形态计量学分析。在检查分布的正态性后，使用参数检验或非参数检验进行统计学比较。
治疗了20例患者（12例男性，8例女性，平均年龄42.8±5.1岁，范围33 - 50岁）。6个月后，两组的牙槽嵴垂直和水平吸收情况相似。模型的3D分析显示颊侧的吸收明显高于腭侧/舌侧。组织形态计量学分析显示，MgHA组（23.07±10.3%）和DBBM组（22.77±6.95%）的新骨形成相似，DBBM组的残留材料百分比（15.77±1.95%）明显高于MgHA组（5.01±1.04%）。MgHA组患者术后前3天报告的疼痛明显较少。
MgHA与DBBM一样安全有效，可能是一种用于牙槽窝保存的可行骨替代物。
