Department of Periodontics, UT Health San Antonio, San Antonio, TX.
J Periodontol. 2020 Oct;91(10):1256-1263. doi: 10.1002/JPER.19-0610. Epub 2020 Mar 3.
To compare the histologic difference in healing between ridge preservation sites treated with a combination allograft of 70% mineralized and 30% demineralized freeze-dried bone allograft (FDBA) evaluated at 8 to 10 weeks versus 18 to 20 weeks post-extraction. Changes in morphological ridge dimensions were also evaluated.
Forty-four patients with a single-rooted tooth to be extracted and replaced by a dental implant were recruited for this study. At time of extraction, measurements were taken with a custom acrylic stent, and the extraction socket was grafted with the combination allograft and covered with a nonresorbable membrane. Patients were randomly assigned to the short-term (8 to 10 weeks) or long-term (18 to 20 weeks) healing group. Sites were re-entered for study measurements, a bone core sample, and implant placement. Bone cores obtained during implant placement were analyzed histologically to determine percentages of vital bone, residual graft, and CT/other.
Thirty-eight of the 44 patients completed the study, 19 in each group. There was a significant difference between the two groups for mean percent vital bone formation (short-term = 18.17%, long-term = 40.32%, P = < 0.0001) and percentage of residual graft (short-term = 41.54%, long-term = 23.59%, P = < 0.0001). There was no difference in morphological changes between the two groups.
Ridge preservation using combination FDBA resulted in approximately twice as much vital bone and half as much residual graft material after 18 to 20 weeks of healing compared to only 8 to 10 weeks healing.
比较在 8 至 10 周与 18 至 20 周拔牙后,用 70%矿化和 30%脱矿冻干骨移植物(FDBA)联合移植物处理的保存脊位点之间愈合的组织学差异。还评估了形态学嵴尺寸的变化。
这项研究招募了 44 名需要拔牙并用种植牙替代的单根牙患者。在拔牙时,使用定制的丙烯酸支架进行测量,并用联合移植物移植拔牙窝并用不可吸收膜覆盖。患者随机分为短期(8 至 10 周)或长期(18 至 20 周)愈合组。在研究测量、骨芯样本和种植体放置时重新进入部位。在放置种植体期间获得的骨芯样本进行组织学分析,以确定活骨、残留移植物和 CT/其他的百分比。
44 名患者中有 38 名完成了研究,每组 19 名。两组之间平均活骨形成百分比(短期=18.17%,长期=40.32%,P<0.0001)和残留移植物百分比(短期=41.54%,长期=23.59%,P<0.0001)有显著差异。两组之间形态学变化无差异。
与仅 8 至 10 周愈合相比,用 FDBA 联合移植物进行牙槽嵴保存后,18 至 20 周愈合时,活骨约增加两倍,残留移植物材料减少一半。