Department of Periodontology and Oral Implantology, Faculty of Dentistry, School of Dentistry, Universidad de Los Andes, Monseñor Álvaro del Portillo12455, Las Condes, Santiago, Chile.
Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium.
Clin Oral Investig. 2020 Mar;24(3):1151-1160. doi: 10.1007/s00784-019-02922-z. Epub 2019 Jul 10.
The aim of this study was to describe the histological and clinical outcome of "dentin block" (a mixture of autologous particulate dentin, leukocyte- and platelet-rich fibrin (L-PRF), and liquid fibrinogen) in alveolar ridge preservation.
Ten extraction sockets were grafted with "dentin block," a mixture of particulate autologous dentin with chopped leukocyte-platelet-rich fibrin (L-PRF) membranes at a 1:1 ratio, and liquid fibrinogen as a binder. Two grafted sites were followed at 4 and 5 months, and 6 sites at 6 months. Biopsies were taken from the core of the grafted site for histologic and histo-morphometric analysis.
All patients completed the study without any adverse event. The vertical and horizontal dimensions of the alveolar ridge were preserved or even increased after 4, 5, or 6 months and remained stable after 6 months of the implant placement. The histological examination revealed a median relative percentage of bone, dentin, and connective tissue of 57.0, 0.9, and 39.3%, respectively. A comparison of samples at different time points (4, 5, and 6 months) showed a progressive increase in the proportion of bone with a decrease in the proportion of dentin. The bone was compact with normal osteocytes and moderate osteoblastic activity. In 4 out of 10 samples, no dentin was observed; in the other samples, it represented 1-5% (with geometric fragments).
Dentin block showed to be a suitable bone substitute in an alveolar ridges preservation model.
The promising results of dentin block as a bone substitute in alveolar ridge preservation could have an important clinical impact considering this biomaterial brings together the regenerative potential of three autologous products with excellent biological and clinical behavior, low risk of adverse effects, and feasible acquisition.
本研究旨在描述“牙本质块”（一种自体颗粒状牙本质、富含白细胞和血小板的纤维蛋白（L-PRF）和液体纤维蛋白原的混合物）在牙槽嵴保存中的组织学和临床结果。
10 个拔牙窝用“牙本质块”（颗粒状自体牙本质与切碎的富含白细胞和血小板的纤维蛋白（L-PRF）膜以 1:1 的比例混合，并用液体纤维蛋白原作为结合剂）进行移植。其中 2 个移植部位在 4 个月和 5 个月时进行随访，6 个部位在 6 个月时进行随访。从移植部位的核心处采集活检标本进行组织学和组织形态计量学分析。
所有患者均完成了研究，无任何不良事件发生。在植入物放置后 4、5 或 6 个月，牙槽嵴的垂直和水平维度得到了保留甚至增加，并且在 6 个月后保持稳定。组织学检查显示，骨、牙本质和结缔组织的中位数相对百分比分别为 57.0%、0.9%和 39.3%。不同时间点（4、5 和 6 个月）的样本比较显示，骨的比例逐渐增加，牙本质的比例减少。骨组织致密，有正常的骨细胞和适度的成骨细胞活性。在 10 个样本中的 4 个样本中未观察到牙本质，在其余样本中，牙本质占 1-5%（呈几何碎片状）。
牙本质块在牙槽嵴保存模型中表现为一种合适的骨替代物。
考虑到牙本质块作为牙槽嵴保存中的骨替代物具有再生潜力，同时汇集了三种自体产品的优势，具有良好的生物和临床性能、低不良反应风险和可行的获取途径，因此其结果具有重要的临床意义。
