Department of Periodontics, School of Dentistry, Creighton University, Omaha, NE.
J Periodontol. 2019 Oct;90(10):1106-1115. doi: 10.1002/JPER.18-0737. Epub 2019 Apr 25.
Evidence exists on the clinical efficacy and safety of periodontally accelerated osteogenic orthodontics (PAOO) with "Piezocision"-a minimally invasive, flapless alternative to corticotomy for alveolar bone augmentation. Allograft has been extensively studied for alveolar bone augmentation in Piezocision; however, the use of deproteinized bovine bone mineral with 10% collagen (DBBM-C) in Piezocision for PAOO has not been investigated.
This study is a prospective, observational, cohort study of 19 patients of Angle Class I malocclusion with a total of 692 teeth assessed for maintenance of health of the periodontal attachment apparatus. Patient-centered pain, sensitivity, and satisfaction outcomes, digital photographs and radiographs, and changes in probing depth, clinical attachment level, width of keratinized tissue, percussion sensitivity, pulp vitality tests, radiographic pathology, and root-crown-ratio were all recorded.
Overall treatment was significantly faster (5 to 7 days between clear aligner tray changes), periodontal parameters remained stable, and alveolar bone loss was not observed. Visual analog score for healing, sensitivity/duration, bleeding/duration, swelling/duration, appearance, and inflammation, demonstrated no significant differences between DBBM-C and control (no bone graft) groups. Patient-centered outcomes revealed high levels of satisfaction with Piezocision. Piezocision-treated teeth with DBBM-C tended to exhibit less root resorption, although it was not statistically significant (P = 0.074).
Within the limits of the study, our results show that the use of DBBM-C with piezosurgically enhanced orthodontics is effective and safe. This study was not designed to demonstrate equivalence with other materials that might be used in Piezocision. To understand whether there is an advantage to using DBBM-C, additional studies may be required.
有证据表明，牙周加速成骨正畸（PAOO）与“Piezocision”相结合具有临床疗效和安全性，后者是一种微创、无瓣的牙槽骨增强替代皮质切开术。同种异体移植物已广泛研究用于 Piezocision 中的牙槽骨增强；然而，在 Piezocision 中使用含 10%胶原的脱蛋白牛骨矿物质（DBBM-C）进行 PAOO 尚未被研究。
这是一项针对 Angle 类 I 错颌畸形的 19 名患者的前瞻性、观察性队列研究，共评估了 692 颗牙齿以维持牙周附着器的健康。记录了以患者为中心的疼痛、敏感和满意度结果、数字照片和射线照片以及探诊深度、临床附着水平、角化组织宽度、叩诊敏感度、牙髓活力测试、射线照相病理学和根冠比的变化。
总体治疗速度明显加快（透明矫正器托盘更换之间 5-7 天），牙周参数保持稳定，未观察到牙槽骨丢失。愈合、敏感/持续时间、出血/持续时间、肿胀/持续时间、外观和炎症的视觉模拟评分在 DBBM-C 组和对照组（无骨移植）之间无显著差异。以患者为中心的结果显示，对 Piezocision 的满意度很高。尽管差异无统计学意义（P=0.074），但用 DBBM-C 处理的 Piezocision 牙齿的根吸收程度较低。
在研究范围内，我们的结果表明，在 Piezosurgically 增强正畸中使用 DBBM-C 是有效和安全的。本研究的设计并非旨在证明与可能在 Piezocision 中使用的其他材料等效。要了解使用 DBBM-C 是否有优势，可能需要进行更多的研究。
