Stumbras Arturas, Kuliesius Povilas, Januzis Gintaras, Juodzbalys Gintaras
Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, KaunasLithuania.
Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, KaunasLithuania.
J Oral Maxillofac Res. 2019 Mar 31;10(1):e2. doi: 10.5037/jomr.2019.10102. eCollection 2019 Jan-Mar.
To review and assess the efficiency of different post extraction socket preservation techniques.
An electronic literature search was performed on the MEDLINE and Embase databases. The review included human studies published between from January 1, 2007 to January 1, 2018, in English. Outcome measures included dimensional changes and/or histological evaluation of alveolar bone.
Twenty-six full text articles were reviewed, 16 of which met the inclusion criteria and were selected for the study. Autogenous tooth graft prevented vertical resorption the most: -0.28 (SD 0.13) mm, observation period (OP): 4 months, while the least effective approach was beta tri-calcium phosphate (β-TCP): -1.72 (SD 0.56) mm, OP: 4 months. Estimating horizontal resorption, the most effective technique was biphasic calcium sulphate (BCS) with β-TCP and hydroxyapatite (HA) - BCS + TCP + HA: 0.03 (SD 2.32) mm, OP: 4 months, while β-TCP was the least efficient: -1.45 (SD 0.4) mm, OP: 4 months. Evaluating residual graft particles (RG) and newly formed bone (NFB) ratio the best results were achieved with demineralized freeze-dried bone allograft: RG: 8.88%, NFB: 38.42%, OP: 5 months, whereas magnesium-enriched hydroxyapatite was least effective: RG: 40.82%, NFB: 31.85%, OP: 4 months.
This review revealed that even though there are numerous types of biomaterials for socket preservation none of them can completely stop alveolar bone loss after tooth extraction. Furthermore, lack of information about qualitative evaluation of bone was noticed indicating that further studies regarding this topic are needed.
回顾并评估不同拔牙后牙槽窝保存技术的有效性。
在MEDLINE和Embase数据库进行电子文献检索。该综述纳入2007年1月1日至2018年1月1日期间发表的英文人体研究。观察指标包括牙槽骨的尺寸变化和/或组织学评估。
共查阅26篇全文文章,其中16篇符合纳入标准并被选入本研究。自体牙移植对防止垂直吸收效果最佳:-0.28(标准差0.13)mm,观察期(OP):4个月,而效果最差的方法是β-磷酸三钙(β-TCP):-1.72(标准差0.56)mm,OP:4个月。估计水平吸收时,最有效的技术是双相硫酸钙(BCS)联合β-TCP和羟基磷灰石(HA)-BCS+TCP+HA:0.03(标准差2.32)mm,OP:4个月,而β-TCP效率最低:-1.45(标准差0.4)mm,OP:4个月。评估残余移植颗粒(RG)与新形成骨(NFB)的比例,脱矿冻干骨同种异体移植效果最佳:RG:8.88%,NFB:38.42%,OP:5个月,而富镁羟基磷灰石效果最差:RG:40.82%,NFB:31.85%,OP:4个月。
本综述表明,尽管有多种用于牙槽窝保存的生物材料,但没有一种能完全阻止拔牙后牙槽骨吸收。此外,注意到缺乏关于骨质量评估的信息,这表明需要对此主题进行进一步研究。