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皮质松质冻干骨移植物联合/不联合自体骨用于水平骨嵴增高的放射学和组织学评价:一项随机对照临床试验。

Radiological and histological evaluation of horizontal ridge augmentation using corticocancellous freeze-dried bone allograft with and without autogenous bone: A randomized controlled clinical trial.

机构信息

Department of Periodontics, Kashan Dental School, Kashan University of Medical Sciences, Kashan, Iran.

Henry M. Goldman School of Dental Medicine, Boston University, Boston, Massachusetts, USA.

出版信息

Clin Implant Dent Relat Res. 2020 Oct;22(5):582-592. doi: 10.1111/cid.12935. Epub 2020 Sep 9.

Abstract

PURPOSE

The purpose of this study was radiological and histological evaluation of horizontal ridge augmentation using corticocancellous freeze-dried bone allograft (FDBA) with and without autogenous bone (AB).

MATERIALS AND METHODS

The present research was conducted on 42 patients (27 females and 15 males) with insufficient width of edentulous ridge. The patients were randomly assigned into two groups, FDBA alone + collagen membrane (n = 21) and the combined FDBA and AB + collagen membrane (n = 21). The horizontal alveolar ridge dimensions were measured using cone-beam computerized tomography before and 6 months after alveolar ridge augmentation. At the time of insertion of implants, biopsy of new bone was taken from 11 patients in each group and was analyzed histologically. The obtained data were statistically analyzed with paired t test and two-sample t test. The registration number was IRCT201109165305N3.

RESULTS

The mean ± SD ridge width gain after 6 months at the distance of 0, 2, 4, and 6 mm from crest of alveolar ridge was 2.78 ± 1.44, 3.05 ± 1.21, 2.82 ± 1.62, and 2.23 ± 1.95 mm in the FDBA group and 2.40 ± 1.60, 3.10 ± 1.80, 3.60 ± 1.87, and 2.65 ± 2.39 mm in the combined group, respectively, which was statistically significant in both groups using paired t test (P < .001). However, the difference between two groups analyzed by two-sample t test was not statistically significant (P > .05). Amount of new bone generation, remained particles, and connective tissue was not statistically different between two groups (P = .367, P = .428, and P = .598, respectively).

CONCLUSION

Based on the results of this study, corticocancellous FDBA granules along with collagen membrane can successfully be used for horizontal augmentation of edentulous ridge, and adding AB to the granules of FDBA does not significantly increase the quality and quantity of regenerated bone.

摘要

目的

本研究旨在通过皮质松质冻干骨移植物(FDBA)联合和不联合自体骨(AB)进行水平牙槽嵴增量的放射学和组织学评估。

材料与方法

本研究纳入 42 名(女 27 名,男 15 名)无牙颌牙槽嵴宽度不足的患者。患者随机分为两组,单纯 FDBA+胶原膜组(n = 21)和 FDBA 联合 AB+胶原膜组(n = 21)。在牙槽嵴增量前和 6 个月后,使用锥形束计算机断层扫描(CBCT)测量水平牙槽嵴的尺寸。在植入物植入时,从每组的 11 名患者中取出新骨活检,并进行组织学分析。采用配对 t 检验和两样本 t 检验对获得的数据进行统计学分析。注册号为 IRCT201109165305N3。

结果

在距离牙槽嵴顶 0、2、4 和 6mm 处,6 个月后 FDBA 组的平均(±SD)嵴宽度增加分别为 2.78±1.44、3.05±1.21、2.82±1.62 和 2.23±1.95mm,联合组分别为 2.40±1.60、3.10±1.80、3.60±1.87 和 2.65±2.39mm,两组均有统计学意义(P<0.001)。然而,两组间的差异用两样本 t 检验分析时无统计学意义(P>0.05)。两组间新骨生成量、残留颗粒和结缔组织无统计学差异(P=0.367、P=0.428 和 P=0.598)。

结论

基于本研究结果,皮质松质 FDBA 颗粒联合胶原膜可成功用于无牙颌牙槽嵴的水平增量,而向 FDBA 颗粒中添加 AB 并不能显著增加再生骨的质量和数量。

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