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骨替代材料或富含生长因子的富血小板血浆行牙槽嵴保存术后的三维分析:随机对照临床试验。

Three-dimensional analysis of dimensional changes after alveolar ridge preservation with bone substitutes or plasma rich in growth factors: Randomized and controlled clinical trial.

机构信息

Oral and Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania.

Oral Surgery and Implant Dentistry Department, University of Granada, Granada, Andalucía, Spain.

出版信息

Clin Implant Dent Relat Res. 2021 Feb;23(1):96-106. doi: 10.1111/cid.12950. Epub 2020 Oct 20.

DOI:10.1111/cid.12950
PMID:33084205
Abstract

OBJECTIVES

To evaluate alveolar ridge dimensional changes of different alveolar ridge preservation techniques after 3 months of tooth extraction and to compare the efficacy of autologous plasma rich in growth factor (PRGF) to the bone substitutes in alveolar ridge preservation and sites left to heal spontaneously.

MATERIALS AND METHODS

Forty patients requiring tooth extraction in the anterior maxilla were randomly allocated to the four following 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 PRGF alone. Cone beam computed tomography (CBCT) scans were taken after surgery and 3 months later. The measurements of height and width (at 1, 3, and 5 mm below the crest) were performed after superimposing the 2 consecutive CBCT scans.

RESULTS

The greatest horizontal alveolar bone resorption at 1 mm below bone crest was observed in the control group (-1.61 ± 1.76 mm, P = .037), whereas the least reduction in width was found in the BBM/CM group (-0.68 ± 0.67 mm, P = .037). The most pronounced alveolar height reduction was observed in the control group (-0.86 ± 0.43 mm), whereas alveolar ridge preservation with BBMC/CM (-0.26 ± 0.91 mm) and PRGF (-0.54 ± 0.86 mm) successfully reduced the alveolar height reduction as compared to the control group.

CONCLUSIONS

Alveolar ridge preservation technique in the esthetic zone using BBM/CM or using PRGF is beneficial to reduce horizontal and vertical bone changes.

摘要

目的

评估拔牙后 3 个月不同牙槽嵴保存技术的牙槽嵴尺寸变化,并比较富含生长因子的自体血浆(PRGF)与骨替代物在牙槽嵴保存和自然愈合部位的疗效。

材料和方法

40 例需要在前上颌拔牙的患者随机分为以下 4 种治疗方式:自发愈合(对照组)、天然牛骨矿物质覆盖可吸收天然胶原膜(BBM/CM)、冻干骨移植物覆盖可吸收天然胶原膜(FDBA/CM)和 PRGF 单独使用。术后和 3 个月后分别进行锥形束 CT(CBCT)扫描。在叠加连续 2 次 CBCT 扫描后,对高度和宽度(嵴下 1、3 和 5mm 处)进行测量。

结果

在骨嵴下 1mm 处,对照组的水平牙槽骨吸收最大(-1.61±1.76mm,P=0.037),而 BBM/CM 组的宽度减少最小(-0.68±0.67mm,P=0.037)。对照组的牙槽骨高度降低最明显(-0.86±0.43mm),而 BBM/CM (-0.26±0.91mm)和 PRGF(-0.54±0.86mm)的牙槽嵴保存成功降低了与对照组相比的牙槽骨高度降低。

结论

在美学区域使用 BBM/CM 或使用 PRGF 的牙槽嵴保存技术有利于减少水平和垂直骨变化。

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