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比较块状和颗粒状骨替代物引导性骨再生种植体周围缺损后硬组织的变化:一项随机对照临床试验的 6 个月结果。

Hard tissue changes after guided bone regeneration of peri-implant defects comparing block versus particulate bone substitutes: 6-month results of a randomized controlled clinical trial.

机构信息

Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.

出版信息

Clin Oral Implants Res. 2019 Oct;30(10):1016-1026. doi: 10.1111/clr.13515. Epub 2019 Aug 8.

Abstract

OBJECTIVES

To test whether block bone substitute used for guided bone regeneration (GBR) of peri-implant defects leads to different thickness of the augmented hard tissue than particulate bone substitute.

MATERIAL AND METHODS

In 24 patients, 24 two-piece dental implants were placed >4 months after tooth extraction. Following random allocation, 12 peri-implant bone dehiscences were grafted with an individually shaped block of deproteinized bovine-derived bone mineral (DBBM) and 12 bone dehiscences with particulate DBBM. All the sites were covered with a collagen membrane stabilized with resorbable pins. Immediately after wound closure and after 6 months, the horizontal thickness (HT) of the augmented hard tissue was measured at the level of implant shoulder using cone beam-computed tomography.

RESULTS

After wound closure, the median HT measured 3.35 mm (mean: 3.38) in the block group and 2.85 mm (mean: 2.73) in the particulate group. At 6 months, the median HT decreased to 2.90 mm (mean: 2.71) in the block group and to 0.2 mm (mean: 0.52) in the particulate group. This difference was statistically significant (p < .001).

CONCLUSIONS

Block bone substitute used for GBR of peri-implant defects was superior to particulate bone substitute regarding the dimension of the augmented hard tissue after 6 months of healing.

摘要

目的

检验块状骨替代物应用于种植体周围骨缺损引导骨再生(GBR)是否会产生比颗粒状骨替代物更厚的增强硬组织。

材料和方法

24 名患者在拔牙后>4 个月时植入 24 颗两段式牙种植体。按照随机分配,12 个种植体周围骨裂开处用个体化成形的脱蛋白牛源性骨矿物质(DBBM)块状物进行移植,12 个骨裂开处用颗粒状 DBBM 进行移植。所有部位均用胶原膜覆盖并用可吸收钉稳定。在伤口闭合后即刻和 6 个月时,使用锥形束 CT 测量种植体肩水平增强硬组织的水平厚度(HT)。

结果

在伤口闭合时,块状组的中位数 HT 为 3.35mm(平均值:3.38),颗粒组为 2.85mm(平均值:2.73)。6 个月时,块状组的中位数 HT 降低至 2.90mm(平均值:2.71),颗粒组降低至 0.2mm(平均值:0.52)。这一差异具有统计学意义(p<.001)。

结论

块状骨替代物应用于种植体周围骨缺损 GBR 在 6 个月的愈合期后,在增强硬组织的尺寸方面优于颗粒状骨替代物。

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