不同引导骨再生材料应用下伤口闭合对骨量稳定性的影响：一项锥形束计算机断层扫描研究

Influence of wound closure on volume stability with the application of different GBR materials: an cone-beam computed tomographic study.

作者信息

Naenni Nadja, Berner Tanja, Waller Tobias, Huesler Juerg, Hämmerle Christoph Hans Franz, Thoma Daniel Stefan

机构信息

Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.

出版信息

J Periodontal Implant Sci. 2019 Feb 22;49(1):14-24. doi: 10.5051/jpis.2019.49.1.14. eCollection 2019 Feb.

PURPOSE

To assess the influence of using different combinations of guided bone regeneration (GBR) materials on volume changes after wound closure at peri-implant dehiscence defects.

METHODS

In 5 pig mandibles, standardized bone defects were created and implants were centrally placed. The defects were augmented using different combinations of GBR materials: xenogeneic granulate and collagen membrane (group 1, n=10), xenogeneic granulate and alloplastic membrane (group 2, n=10), alloplastic granulates and alloplastic membrane (group 3, n=10). The horizontal thickness was assessed using cone-beam computed tomography before and after suturing. Measurements were performed at the implant shoulder (HT0) and at 1 mm (HT1) and 2 mm (HT2) below. The data were statistically analysed using the Wilcoxon signed-rank test to evaluate within-group differences. Bonferroni correction was applied when calculating statistical significance between the groups.

RESULTS

The mean horizontal thickness before suturing was 2.55±0.53 mm (group 1), 1.94±0.56 mm (group 2), and 2.49±0.73 mm (group 3). Post-suturing, the values were 1.47±0.31 mm (group 1), 1.77±0.27 mm (group 2), and 2.00±0.48 mm (group 3). All groups demonstrated a loss of horizontal dimension. Intragroup changes exhibited significant differences in group 1 (<0.001) and group 3 (<0.01). Intergroup comparisons revealed statistically significant differences of the relative changes between groups 1 and 2 (=0.033) and groups 1 and 3 (=0.015).

CONCLUSIONS

Volume change after wound closure was minimized by using an alloplastic membrane. The stability of the augmented horizontal thickness was most ensured by using this type of membrane irrespective of the bone substitute material used for membrane support.

目的

评估使用不同组合的引导骨再生（GBR）材料对种植体周围裂开性缺损伤口闭合后体积变化的影响。

方法

在5头猪的下颌骨中制造标准化骨缺损，并将种植体置于中心位置。使用不同组合的GBR材料对缺损进行增量处理：异种颗粒和胶原膜（第1组，n = 10）、异种颗粒和异质材料膜（第2组，n = 10）、异质材料颗粒和异质材料膜（第3组，n = 10）。在缝合前后使用锥形束计算机断层扫描评估水平厚度。在种植体肩部（HT0）以及其下方1 mm（HT1）和2 mm（HT2）处进行测量。使用Wilcoxon符号秩检验对数据进行统计分析，以评估组内差异。在计算组间统计显著性时应用Bonferroni校正。

结果

缝合前的平均水平厚度在第1组为2.55±0.53 mm，第2组为1.94±0.56 mm，第3组为2.49±0.73 mm。缝合后，第1组的值为1.47±0.31 mm，第2组为1.77±0.27 mm，第3组为2.00±0.48 mm。所有组均显示水平尺寸减小。第1组（<0.001）和第3组（<0.01）的组内变化表现出显著差异。组间比较显示，第1组和第2组（= 0.033）以及第1组和第3组（= 0.015）之间的相对变化存在统计学显著差异。