Department of Periodontology, Research Institute for Periodontal regeneration, Yonsei University College of Dentistry, Seoul, Korea.
Department of Applied Life Science, BK21 PLUS, Yonsei University College of Dentistry, Seoul, Korea.
Clin Oral Implants Res. 2020 Jan;31(1):93-102. doi: 10.1111/clr.13557. Epub 2019 Nov 27.
This study histologically analyzed biopsy samples obtained from sites of damaged extraction socket grafting using deproteinized bovine bone mineral (DBBM) or deproteinized porcine bone mineral (DPBM) with coverage by a collagen membrane.
One hundred patients participated in this randomized controlled clinical trial of extraction socket grafts performed in cases of periodontally compromised teeth. All participants were blinded to their group allocations, and each material was grafted with coverage by collagen membranes after extraction of the tooth and removal of granulation tissue. At implant placement at 4 months, a biopsy was harvested at the implant site using a trephine was analyzed histologically.
Eighty-five biopsy samples were acquired, of which 81 were finally included in the histologic analysis (42 in DBBM and 39 in DPBM group). Both DBBM and DPBM groups showed comparable proportions of residual biomaterial (12.37 ± 5.67% and 12.21 ± 5.75%, respectively), newly formed bone (15.07 ± 10.52% and 18.47 ± 11.47%, respectively), and nonmineralized tissue (72.56 ± 10.07% and 71.55 ± 15.47%, respectively). There were no significant differences in these histologic parameters between the two groups with different biomaterials.
Comparable histologic bone formation was found in both socket grafted groups with DBBM or DPBM covered by collagen membranes in periodontally damaged extraction sockets. However, a wide variation in new bone formation was found after 4 months of postsurgical healing and a tendency of higher new bone formation was shown at damaged sockets that had an intact unilateral residual wall regardless of buccal or lingual side.
本研究通过组织学分析，比较使用脱蛋白牛骨矿物质（DBBM）或脱蛋白猪骨矿物质（DPBM）联合胶原膜覆盖牙周受损拔牙窝骨增量后活检样本。
100 名患者参与了本项关于牙周病损牙齿拔牙窝骨增量的随机对照临床试验。所有参与者均对分组情况进行了盲法处理，在拔牙和去除肉芽组织后，分别使用胶原膜覆盖每种材料。在 4 个月时进行种植体植入，使用环钻在种植体部位取活检，进行组织学分析。
共获得 85 个活检样本，其中 81 个最终纳入组织学分析（DBBM 组 42 个，DPBM 组 39 个）。DBBM 和 DPBM 组的残留生物材料比例相似（分别为 12.37±5.67%和 12.21±5.75%），新骨形成比例相似（分别为 15.07±10.52%和 18.47±11.47%），非矿化组织比例相似（分别为 72.56±10.07%和 71.55±15.47%）。两组间不同生物材料的这些组织学参数均无显著差异。
在牙周受损拔牙窝中，使用胶原膜覆盖 DBBM 或 DPBM 均可获得类似的组织学骨形成，但在术后 4 个月的愈合过程中，新骨形成的变化较大，且无论颊侧或舌侧，单侧完整残壁的受损牙槽窝有更高的新骨形成趋势。
