Assistant Professor, Graduate Periodontics, University of Louisville, Louisville, KY.
Director of Graduate Periodontics, University of Louisville, Louisville, KY.
Implant Dent. 2019 Dec;28(6):613-620. doi: 10.1097/ID.0000000000000925.
The primary aim of this randomized, controlled, blinded, clinical trial was to compare a mix of particulate allograft and harvested autogenous particles (Autogenous) to an osteoinductive demineralized bone matrix (DBM) allograft on clinical and histologic outcomes for horizontal ridge augmentation procedure.
Fourteen patients with a horizontal ridge defect with at least 1 adjacent tooth were entered into this study. The test group of 7 subjects received corticocancellous particulate allograft (Mineross) mixed with autogenous bone chips (70:30) harvested using a bone scraper (SafeScraper TWIST). Seven subjects in the control group received DBM (Optecure-CCC). Both groups had a corticocancellous particulate allograft overlay and an acellular dermis membrane (ADMG) (AlloDerm GBR) to cover the grafts.
For the Autogenous group, there was a gain of 3.5 ± 1.4 mm while the DBM group gained 3.8 ± 1.6 mm (P < 0.05). Vertical change was minimal for both groups (P > 0.05). The Autogenous group had a mean of 35% vital bone while the DBM had 39% (P > 0.05).
Both treatments provided similar gain of ridge width and minimal loss of ridge height. The autogenous bone chips did not provide any additional benefit when compared with allograft alone that had lot verified osteoinductive activity.
本随机、对照、盲法临床试验的主要目的是比较颗粒状同种异体移植物和自体颗粒(自体)与诱导成骨脱矿骨基质(DBM)同种异体移植物在水平牙槽嵴增量程序中的临床和组织学结果。
14 名有至少 1 颗相邻牙齿的水平牙槽嵴缺损患者纳入本研究。7 名受试者的实验组接受皮质松质颗粒状同种异体移植物(Mineross)与使用骨刮板(SafeScraper TWIST)采集的自体骨屑(70:30)混合。对照组 7 名受试者接受 DBM(Optecure-CCC)。两组均有皮质松质颗粒状同种异体移植物覆盖和无细胞真皮膜(ADMG)(AlloDerm GBR)覆盖移植物。
自体组的增益为 3.5±1.4mm,而 DBM 组的增益为 3.8±1.6mm(P<0.05)。两组的垂直变化都很小(P>0.05)。自体组有 35%的活骨,而 DBM 组有 39%(P>0.05)。
两种治疗方法都提供了相似的牙槽嵴宽度增加和最小的牙槽嵴高度损失。与具有大量验证的成骨活性的单独同种异体移植物相比,自体骨屑没有提供任何额外的益处。