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使用脱矿冻干骨同种异体移植物和富血小板纤维蛋白进行种植位点开发的牙槽窝保存:一项随机对照试验。

Socket preservation with demineralized freeze-dried bone allograft and platelet-rich fibrin for implant site development: A randomized controlled trial.

作者信息

Dhamija Ridhima, Shetty Vibha, Vineeth K, Nagaraju Rakesh, Rao Roopa S

机构信息

Department of Prosthodontics, M S Ramaiah Dental College and Hospital, Bengaluru, Karnataka, India.

Department of Oral and Maxillofacial Surgery, M S Ramaiah Dental College and Hospital, Bengaluru, Karnataka, India.

出版信息

J Indian Prosthodont Soc. 2020 Jul-Sep;20(3):304-311. doi: 10.4103/jips.jips_2_20. Epub 2020 Jul 17.

Abstract

AIM

This study compared clinical, histological, and radiological differences in bone formation in human extraction sockets grafted with demineralized freeze-dried bone allograft (DFDBA) and platelet-rich fibrin (PRF), with nongrafted sockets and bone-implant contact (BIC) at 3 and 6 months after implant placement.

SETTINGS AND DESIGN

Randomised controlled trial.

MATERIALS AND METHODS

The study comprised thirty posterior teeth sockets in either arch in patients ranging from 25 to 60 years. The patients were divided into two equal groups - Group I: control group wherein no graft was placed and the extraction socket was left to heal normally and Group II: test group in which DFDBA and PRF were placed after extraction. 12-16 weeks after extraction, a trephine biopsy was done just prior to implant placement, followed by implant placement. Cone-beam computed tomography (CBCT) at 3 and 6 months after implant placement was done to assess BIC.

STATISTICAL ANALYSIS USED

Descriptive and Inferential statistical analysis was done. Parametric test: Independent -test was used for intergroup analysis and dependent -test for intra-group analysis.

RESULTS

Lower buccal bone levels were seen in the control group versus test group at all intervals though moderately significant. Lingual bone levels significantly reduced at all the three intervals for the control group as compared to the test group. Ridge width in both groups reduced in a time span of 6-7 months without any significant difference. Better bone conversion was noted in the preserved sockets. The preserved sockets also showed better BIC 3 months after implant placement and loading.

CONCLUSION

Indigenously developed DFDBA material shows promising results as an osteoinductive material.

摘要

目的

本研究比较了在植入种植体后3个月和6个月时,用脱矿冻干同种异体骨(DFDBA)和富血小板纤维蛋白(PRF)移植的人类拔牙窝与未移植的拔牙窝及骨-种植体接触(BIC)情况在临床、组织学和放射学上骨形成的差异。

设置与设计

随机对照试验。

材料与方法

该研究纳入了年龄在25至60岁之间患者任一牙弓中的30个后牙拔牙窝。患者被分为两个相等的组——第一组:对照组,不进行移植,拔牙窝任其自然愈合;第二组:试验组,拔牙后植入DFDBA和PRF。拔牙后12 - 16周,在植入种植体前进行环钻活检,随后植入种植体。在植入种植体后3个月和6个月进行锥形束计算机断层扫描(CBCT)以评估骨-种植体接触情况。

所用统计分析方法

进行描述性和推断性统计分析。参数检验:组间分析采用独立t检验,组内分析采用相关t检验。

结果

在所有时间间隔,对照组的颊侧骨水平均低于试验组,尽管差异为中度显著。与试验组相比,对照组在所有三个时间间隔的舌侧骨水平均显著降低。两组的牙槽嵴宽度在6 - 7个月的时间跨度内均减小,无显著差异。在保留的拔牙窝中观察到更好的骨转化。保留的拔牙窝在植入种植体并加载后3个月时也显示出更好的骨-种植体接触情况。

结论

自主研发的DFDBA材料作为一种骨诱导材料显示出有前景的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48fd/7654195/3c96fce04021/JIPS-20-304-g001.jpg

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