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即刻种植与拔牙后自然愈合对牙槽嵴保存效果的比较:一项随机对照临床试验的影像学结果。

The effect of immediate implant placement on alveolar ridge preservation compared to spontaneous healing after tooth extraction: Radiographic results of a randomized controlled clinical trial.

机构信息

Department of Periodontology, Università Vita-Salute San Raffaele, Milan, Italy.

University Centre of Statistics for Biomedical Sciences (CUSSB), Università Vita-Salute San Raffaele, Milan, Italy.

出版信息

J Clin Periodontol. 2019 Jul;46(7):776-786. doi: 10.1111/jcpe.13125. Epub 2019 May 31.

Abstract

AIM

To radiographically evaluate the effect of immediate implant placement plus alveolar ridge preservation (ARP) with a deproteneized bovine bone mineral and a collagen matrix (IMPL/DBBM/CM) as compared to ARP (DBBM/CM) or spontaneous healing (SH) on vertical and horizontal bone dimensional changes after 4 months of healing.

MATERIALS AND METHODS

Thirty patients requiring extraction of one single-rooted tooth or premolar were randomly assigned to IMPL/DBBM/CM, ARP DBBM/CM or SH. Cone-beam computed tomography (CBCT) scans, performed before tooth extraction and after 4 months, were superimposed in order to assess changes in ridge height at the buccal and lingual aspect and in ridge width at 1 mm, 3 mm and 5 mm apical to the bone crest. Kruskal-Wallis test was applied for comparison of differences between groups.

RESULTS

No statistically significant differences between the groups were observed for the vertical bone resorption of the buccal and the lingual side, while significant differences were found between SH group (-3.37 ± 1.55 mm; -43.2 ± 25.1%) and both DBBM/CM (-1.56 ± 0.76 mm; -19.2 ± 9.1%) and IMPL/DBBM/CM (-1.29 ± 0.38 mm; -14.9 ± 4.9%) groups in the horizontal dimension at the most coronal aspect.

CONCLUSION

Ridge preservation techniques using DBBM and CM reduce the horizontal bone morphological changes that occur, mostly in the coronal portion of the buccal bone plate following tooth extraction, when compared to spontaneous healing. This is true regardless of whether immediate implant placement is performed or not.

摘要

目的

与牙槽嵴保存(ARP)(DBBM/CM)或自发愈合(SH)相比,评价即刻种植加脱蛋白牛骨矿物质和胶原基质(IMPL/DBBM/CM)的放射影像学效果,即在 4 个月愈合后对垂直和水平骨尺寸变化的影响。

材料和方法

30 名需要拔除单根牙或前磨牙的患者被随机分为 IMPL/DBBM/CM、ARP DBBM/CM 或 SH 组。在拔牙前和 4 个月后进行锥形束 CT(CBCT)扫描,以评估颊侧和舌侧牙槽嵴高度的变化,以及在骨嵴 1mm、3mm 和 5mm 处牙槽嵴宽度的变化。应用 Kruskal-Wallis 检验比较组间差异。

结果

在颊侧和舌侧的垂直骨吸收方面,各组间无统计学差异,而 SH 组(-3.37±1.55mm;-43.2±25.1%)与 DBBM/CM 组(-1.56±0.76mm;-19.2±9.1%)和 IMPL/DBBM/CM 组(-1.29±0.38mm;-14.9±4.9%)在最冠方的水平方向上有显著差异。

结论

与自发愈合相比,使用 DBBM 和 CM 的牙槽嵴保存技术可减少拔牙后颊侧骨板最冠部水平骨形态变化,尤其是在牙后。无论是否进行即刻种植,都是如此。

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