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使用异种移植物、同种异体移植物与富含生长因子的血浆进行牙槽嵴保存后骨愈合的随机对照临床试验。

Randomized and Controlled Clinical Trial of Bone Healing After Alveolar Ridge Preservation Using Xenografts and Allografts Versus Plasma Rich in Growth Factors.

作者信息

Stumbras Arturas, Januzis Gintaras, Gervickas Albinas, Kubilius Ricardas, Juodzbalys Gintaras

机构信息

Department of Maxillofacial Surgery, Faculty of Odontology, Lithuanian University of Health Sciences, Kaunas, Lithuania.

出版信息

J Oral Implantol. 2020 Oct 1;46(5):515-525. doi: 10.1563/aaid-joi-D-19-00179.

Abstract

The aim of this study was to compare bone regeneration in the anterior maxilla between bone substitutes and autologous platelet concentrate in alveolar ridge preservation. Forty patients requiring tooth extraction in the anterior maxilla were randomly allocated to the following 4 treatment modalities: spontaneous healing (control), natural bovine bone mineral covered with resorbable native collagen membrane (BBM/CM), freeze-dried bone allograft covered with resorbable native collagen membrane (FDBA/CM), and plasma rich in growth factors (PRGF) alone. Bone biopsies and histomorphometrical analysis were performed after 3 months of healing. The following parameters were assessed: newly formed mineralized tissue, newly formed nonmineralized tissue, and residual bone-grafting material (if applicable). Statistical analysis was performed to provide descriptive analysis and to compare the parameters of the bone regeneration between the study groups. Histomorphometrical analysis revealed the highest new mineralized tissue formation in the PRGF group. Statistically significant differences in new mineralized tissue formation were found between control/PRGF (46.4% ± 15.2% vs 75.5% ± 16.3%), control/(BBM/CM) (46.4% ± 15.2% vs 20.3% ± 21.9%), control/(FDBA/CM) (46.4% ± 15.2% vs 7.2% ± 8.6%), PRGF/(BBM/CM) (75.5% ± 16.3% vs 20.3% ± 21.9%), and PRGF/(FDBA/CM) (75.5% ± 16.3% vs 7.2% ± 8.6%) groups. The new mineralized tissue formation was in the following order: PRGF > control > BBM > FDBA. Alveolar ridge preservation in the esthetic zone with PRGF was the most effective for bone regeneration of the alveolar ridge.

摘要

本研究的目的是比较骨替代物与自体血小板浓缩物在前上颌骨牙槽嵴保存中的骨再生情况。40例需要拔除前上颌骨牙齿的患者被随机分配至以下4种治疗方式:自然愈合(对照组)、覆盖可吸收天然胶原膜的天然牛骨矿物质(BBM/CM)、覆盖可吸收天然胶原膜的冻干同种异体骨(FDBA/CM)以及单独使用富含生长因子的血浆(PRGF)。愈合3个月后进行骨活检和组织形态计量学分析。评估以下参数:新形成的矿化组织、新形成的非矿化组织以及残余骨移植材料(如适用)。进行统计分析以提供描述性分析,并比较研究组之间的骨再生参数。组织形态计量学分析显示PRGF组新矿化组织形成最多。在对照组/PRGF组(46.4%±15.2%对75.5%±16.3%)、对照组/(BBM/CM)组(46.4%±15.2%对20.3%±21.9%)、对照组/(FDBA/CM)组(46.4%±15.2%对7.2%±8.6%)、PRGF/(BBM/CM)组(75.5%±16.3%对20.3%±21.9%)以及PRGF/(FDBA/CM)组(75.5%±16.3%对7.2%±8.6%)之间,新矿化组织形成存在统计学显著差异。新矿化组织形成顺序如下:PRGF>对照组>BBM>FDBA。在美学区域使用PRGF进行牙槽嵴保存对牙槽嵴骨再生最为有效。

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