Cao C, Wang F, Wang E B, Liu Y
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2020 Feb 18;52(1):97-102. doi: 10.19723/j.issn.1671-167X.2020.01.015.
To evaluate the effect of bone defect regeneration and the periodontal status of the second molars after mandibular third molars extraction using β-tertiary calcium phosphate (β-TCP) in the test side compared with the spontaneously healed side. To the bone defect of mandibular second molars as a result of surgical removal of impacted mandibular third molars is a common phenomenon, many research shows that the mandibular second molars alveolar bone regeneration was about 1.5 mm and the periodontal pocket >7 mm was greater than 43.3% after mandibular third molars extraction. There has been significant progress researches in the repair of bone defect after the third molar removal, and bone graft filling was one of the effective methods. The bone graft substitutes include autogenous bone, allograft bone, xenograft bone and synthetic bone.
A split mouth, randomized clinical study was designed. Fifteen patients with mandibular third molars in the same jaw planned to be extracted were enrolled in the study. One of the sockets of each patient was randomly selected and filled with easy-graftTMCLASSIC (test group). The contralateral socket was left to heal spontaneously (control group). cone beam computed tomography (CBCT) scans were performed the day after the extraction and after 6 months. The horizontal dimensional changes of the sockets were recorded. The newly formed bone volume in the bone was analyzed by CBCT, and the probing depth (PD) was recorded. Student's t test was used to evaluate the difference between the two groups for each parameter, and the P value lower than 0.05 was considered to be statistically significant.
Fifteen patients (30 sockets) completed the flow-up, and all the 30 sockets healed uneventfully. After 6 months' healing, the new bone volume fraction of the test group was 63.3%±2.2%, while the new bone volume fraction of the control group was 50.1%±1.9%. The vertical dimensional increment of the test group was (5.53±0.39) mm, while the vertical change of the control group was (1.53±0.27) mm. The distal buccal site PD of the second molar was (3.0±0.7) mm in the test group, and (6.5±0.8) mm in the control group. Statistically significant differences were detected between the two groups.
The randomized controlled clinical trial showed that the application of β-TCP for bone defect repair after the mandibular third molars extraction resulted in more vertical bone regeneration and less probing depth when compared with what was spontaneously healed.
评估在下颌第三磨牙拔除后，使用β-磷酸三钙（β-TCP）的试验侧与自然愈合侧相比，第二磨牙的骨缺损再生效果及牙周状况。因手术拔除下颌阻生第三磨牙导致下颌第二磨牙出现骨缺损是常见现象，许多研究表明，下颌第三磨牙拔除后，下颌第二磨牙牙槽骨再生约1.5毫米，牙周袋>7毫米者大于43.3%。在第三磨牙拔除后骨缺损修复方面已有显著进展研究，植骨填充是有效方法之一。骨移植替代物包括自体骨、同种异体骨、异种骨和合成骨。
设计一项双侧、随机临床研究。纳入15例计划拔除同一颌骨下颌第三磨牙的患者。随机选择每位患者的一个拔牙窝，用易植TM经典型（试验组）填充。对侧拔牙窝让其自然愈合（对照组）。拔牙后第1天和6个月后进行锥形束计算机断层扫描（CBCT）。记录拔牙窝的水平尺寸变化。通过CBCT分析骨内新形成的骨体积，并记录探诊深度（PD）。采用学生t检验评估两组各参数之间的差异，P值低于0.05被认为具有统计学意义。
15例患者（30个拔牙窝）完成随访，所有30个拔牙窝均顺利愈合。愈合6个月后，试验组新骨体积分数为63.3%±2.2%，而对照组新骨体积分数为50.1%±1.9%。试验组垂直尺寸增量为（5.53±0.39）毫米，而对照组垂直变化为（1.53±0.27）毫米。试验组第二磨牙远中颊侧位点PD为（3.0±0.7）毫米，对照组为（6.5±0.8）毫米。两组之间检测到统计学显著差异。
随机对照临床试验表明，下颌第三磨牙拔除后应用β-TCP进行骨缺损修复，与自然愈合相比，可实现更多的垂直骨再生且探诊深度更小。
