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比较伴或不伴釉基质衍生物应用的上前牙槽嵴保存的效果:一项随机临床试验。

Comparative assessment of anterior maxillary alveolar ridge preservation with and without adjunctive use of enamel matrix derivative: A randomized clinical trial.

机构信息

Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea.

出版信息

Clin Oral Implants Res. 2020 Jan;31(1):1-9. doi: 10.1111/clr.13530. Epub 2019 Sep 12.

Abstract

OBJECTIVES

The aim of this randomized, controlled, parallel-arm study was to evaluate the (a) radiographic bone dimensional changes, (b) postoperative discomfort, and (c) early soft tissue wound healing outcomes, following extraction of maxillary anterior teeth (central and lateral incisors) and treatment with alveolar ridge preservation (ARP) with and without the adjunctive use of enamel matrix derivative (EMD).

METHODS

Thirty extraction sockets were randomly assigned to two groups: deproteinized bovine bone mineral with 10% collagen covered with collagen membrane with the adjunctive use of EMD (test group) and without EMD (control group). Bone dimensional changes were measured using cone beam computed tomography at 3 and 5 months after ARP. The severity and duration of pain and swelling were evaluated using self-reported questionnaires, and soft tissue wound healing outcomes were assessed clinically. Chi-square tests and t tests were conducted to compare differences between the two groups.

RESULTS

Radiographic and clinical analyses showed no significant differences in horizontal and vertical bone dimensional changes and soft tissue wound healing outcomes (including spontaneous bleeding, persistent swelling, and ulceration) between the two groups. There were no significant differences in the severity of pain and swelling between the two groups, but the durations of pain (difference [df] = 1.20, 95% CI = 0.33-2.06; p = .008) and swelling (df = 1.06, 95% CI = 0.11-2.01; p = .029) were significantly reduced in the test group.

CONCLUSION

Alveolar ridge preservation with the adjunctive use of EMD reduced the durations of postoperative pain and swelling following maxillary anterior teeth extraction.

摘要

目的

本随机对照平行臂研究旨在评估(a)上颌前牙(中切牙和侧切牙)拔除后牙槽嵴保存(ARP)并用和不用釉基质衍生物(EMD)的附加治疗后,(b)术后不适,(c)早期软组织伤口愈合结果。

方法

将 30 个拔牙窝随机分配到两组:脱蛋白牛骨矿物质加 10%胶原覆盖胶原膜,并用 EMD 附加治疗(试验组)和不用 EMD(对照组)。在 ARP 后 3 个月和 5 个月使用锥形束 CT 测量骨尺寸变化。使用自我报告问卷评估疼痛和肿胀的严重程度和持续时间,并进行临床评估软组织伤口愈合结果。使用卡方检验和 t 检验比较两组之间的差异。

结果

影像学和临床分析显示,两组在水平和垂直骨尺寸变化和软组织伤口愈合结果(包括自发性出血、持续肿胀和溃疡)方面无显著差异。两组疼痛和肿胀的严重程度无显著差异,但试验组疼痛(差异[df] = 1.20,95%置信区间[CI] = 0.33-2.06;p =.008)和肿胀(df = 1.06,95%CI = 0.11-2.01;p =.029)的持续时间显著缩短。

结论

在上颌前牙拔除后,牙槽嵴保存并用 EMD 附加治疗可减少术后疼痛和肿胀的持续时间。

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