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釉基质衍生物对上颌后牙牙槽嵴保存的影响:一项随机对照临床试验。

Effect of enamel matrix derivative on alveolar ridge preservation in the posterior maxilla: A randomized controlled clinical trial.

机构信息

Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, South Korea.

出版信息

Clin Implant Dent Relat Res. 2020 Oct;22(5):622-630. doi: 10.1111/cid.12940. Epub 2020 Sep 9.

Abstract

BACKGROUND

EMD has been considered to exert positive effects on wound healing, postoperative discomfort, and bone regeneration.

PURPOSE

The aim of this randomized controlled clinical trial was to investigate and compare (a) horizontal and vertical bone dimensional changes, (b) early postoperative discomfort and soft tissue wound healing outcomes, and (c) treatment modalities for implant placement, following posterior maxillary alveolar ridge preservation (ARP) with and without adjunctive use of EMD.

METHODS

Twenty-eight participants were randomly assigned to three groups: extraction sockets filled with bovine bone mineral and membrane with EMD (test group 1, n = 10) and without EMD (test group 2, n = 10) and spontaneous healing (control group, n = 8). Alveolar bone dimensional changes were measured using cone-beam computed tomography 5 months after ARP, and postoperative pain and wound healing outcomes were also evaluated.

RESULTS

There were no significant differences in horizontal or vertical bone dimensional changes between test groups 1 (horizontal width changes at 1 mm apically below the alveolar ridge crest [HW]: -1.44 ± 0.54 mm) and 2 (HW: -1.42 ± 0.26 mm), but the changes at HW (-2.36 ± 1.03 mm) in the control group were significantly greater than those in test groups 1 and 2 (P < .05). Early postoperative discomfort and soft tissue wound healing outcomes were not significantly different between the two test groups. Furthermore, unlike the control group, both the test groups 1 and 2 were implanted without sinus floor elevation using the lateral approach.

CONCLUSION

Within the limitations of this study, EMD failed to provide additional benefits in ARP in the posterior maxilla.

摘要

背景

EMD 被认为对伤口愈合、术后不适和骨再生有积极作用。

目的

本随机对照临床试验旨在研究和比较(a)水平和垂直骨尺寸变化,(b)术后早期不适和软组织伤口愈合结果,以及(c)在后牙槽嵴保存(ARP)中附加使用和不使用 EMD 时植入物放置的治疗方式。

方法

将 28 名参与者随机分为三组:用牛骨矿物质和膜填充拔牙窝,并用 EMD(试验组 1,n = 10)和不用 EMD(试验组 2,n = 10)以及自发愈合(对照组,n = 8)。ARP 后 5 个月,使用锥形束计算机断层扫描测量牙槽骨尺寸变化,还评估了术后疼痛和伤口愈合结果。

结果

试验组 1(牙槽嵴顶下 1mm 处的水平宽度变化[HW]:-1.44 ± 0.54mm)和 2(HW:-1.42 ± 0.26mm)之间的水平或垂直骨尺寸变化无显著差异,但对照组的 HW 变化(-2.36 ± 1.03mm)明显大于试验组 1 和 2(P<.05)。两组试验组的早期术后不适和软组织伤口愈合结果无显著差异。此外,与对照组不同,试验组 1 和 2 均采用外侧入路进行植入,无需鼻窦底抬高。

结论

在本研究的限制范围内,EMD 在后牙槽嵴上颌骨保存中未能提供额外的益处。

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