Department of Periodontology, Université Catholique de Louvain (UCL)-Cliniques Universitaires Saint Luc, Avenue Hippocrate 10, 1200, Brussels, Belgium.
Advimago, Center for Advanced Oral Imaging, Rue Emile Claus 42, 1050, Brussels, Belgium.
Clin Oral Investig. 2021 Mar;25(3):1235-1243. doi: 10.1007/s00784-020-03428-9. Epub 2020 Jun 26.
This pilot study aimed to assess dimensional changes following two different alveolar socket sealing techniques.
Twenty-one patients requiring tooth extraction and implant placement were randomly allocated to two different alveolar ridge preservation techniques. In the control group, demineralized bovine bone mineral (DBBM) and a gingival soft tissue punch were used to fill and seal the socket, whereas in the test group, the extraction socket was filled with DBBM and sealed with a hemostatic gelatin sponge. Digitalized impressions were taken before and 6 months after tooth extraction. The comparison was made on horizontal and vertical dimensional changes.
The mean vertical loss was 0.8 ± 0.6 mm for the control group and 0.7 ± 0.5 mm for the test one. No statistical difference was found between groups for the vertical shrinkage. The horizontal dimensional narrowing of the alveolar socket was respectively 7.1/4.0/2.5 mm at levels 1, 3, and 5 mm from a coronal reference level for the control group. The test group showed dimensional changes of 4.8/2.3/1.3 mm at the three different levels, respectively. A significant difference was found at levels 3 and 5 mm. Referring to a visual analog pain scale, patients reported more severe pain in the control group (5.7/10) when compared with the test group (2.8/10). The difference was statistically highly significant (P ≤ 0.001).
A significant difference was found between control and test groups regarding the horizontal dimensional changes and the post-operative pain.
Regarding this primary result, the socket sealing technique with a hemostatic sponge provides an effective and inexpensive protocol with less post-operative pain.
本初步研究旨在评估两种不同牙槽窝封闭技术后的尺寸变化。
21 名需要拔牙和种植的患者被随机分配到两种不同的牙槽嵴保存技术中。在对照组中，使用脱矿牛骨矿物质（DBBM）和牙龈软组织冲头填充和封闭牙槽窝，而在实验组中，用 DBBM 填充拔牙窝并用止血明胶海绵密封。在拔牙前和 6 个月后分别进行数字化印模。比较水平和垂直尺寸变化。
对照组的平均垂直损失为 0.8±0.6mm，实验组为 0.7±0.5mm。两组间的垂直收缩无统计学差异。牙槽窝的水平向缩窄分别为对照组 1 级、3 级和 5 级距冠方参考水平 7.1/4.0/2.5mm。实验组在三个不同水平上分别显示出 4.8/2.3/1.3mm 的尺寸变化。在 3 级和 5 级水平上存在显著差异。参照视觉模拟疼痛量表，对照组（5.7/10）的患者报告疼痛比实验组（2.8/10）更严重。差异具有统计学高度显著性（P≤0.001）。
在水平尺寸变化和术后疼痛方面，对照组和实验组之间存在显著差异。
根据这一初步结果，使用止血海绵的牙槽窝封闭技术提供了一种有效且经济实惠的方案，术后疼痛较轻。
