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成年正畸患者颊侧骨再生联合超声骨刀切开术:临床、三维影像学及患者报告结局

Buccal bone regeneration combined with piezocision in adult orthodontic patients: Clinical, 3D radiographic, and patient-reported outcomes.

作者信息

Charavet Carole, Lecloux Geoffrey, Vandenberghe Bart, Lambert France

机构信息

Department of Orthodontics and DentoFacial Orthopedics, University Hospital of Liège, Liège, Belgium; Université Côte d'Azur, UFR Odontologie, Nice, France; Dental Biomaterials Research Unit (d-BRU), University of Liège, Liège, Belgium.

Department of Periodontology, Oral Surgery and Implant Surgery, University Hospital of Liège, Belgium; Dental Biomaterials Research Unit (d-BRU), University of Liège, Liège, Belgium.

出版信息

J Stomatol Oral Maxillofac Surg. 2021 Dec;122(6):549-556. doi: 10.1016/j.jormas.2020.10.005. Epub 2020 Oct 22.

Abstract

OBJECTIVE

Assess the clinical effects, 3D radiographic results and patient-reported outcome measures (PROMs) of buccal bone regeneration combined with piezocision.

METHODS

Ten patients presenting roots prominence with a thin buccal bone thickness or buccal bone dehiscence in the lower front region were enrolled. Patients received orthodontic treatment assisted by piezocison which was combined with a buccal alveolar bone regeneration using a tunneling approach. A comparison between pre- and post-treatment alveolar bone measurements based on CBCT was performed. Periodontal parameters such as recession scores and root resorption were recorded before and after treatment. The PROMs were also investigated.

RESULTS

An overall significant buccal bone gain of 2.7 ± 2.7% was found after the treatment. The apical region reached the highest gain of 8.9 ± 5.5% whereas the most coronal region showed no significant increase of the bone envelope (1.2 ± 2.7%). No adverse event such as the appearance of recession or root resorption were observed. However, in 2 patients, the biomaterial was not properly integrated and seemed to be encapsulated. The pain level and the paracetamol consumption were equivalent to those after the placement of the orthodontic appliance except on the day of the surgery.

CONCLUSIONS

Within the limitation of this study, piezocision combined with buccal bone regeneration using a tunneling technique seems to be effective to augment bone and did not lead to gingival recession. However, in 2 cases the biomaterial seemed encapsulated, and therefore the predictability of the integration of the material can be questioned. ClinicalTrials.gov registration : NCT03655938.

摘要

目的

评估颊侧骨再生联合压电切开术的临床效果、三维影像学结果及患者报告结局指标(PROMs)。

方法

纳入10例下颌前部区域存在牙根突出、颊侧骨壁薄或颊侧骨缺损的患者。患者接受压电切开辅助的正畸治疗,该治疗联合采用隧道技术进行颊侧牙槽骨再生。基于CBCT对治疗前后的牙槽骨测量结果进行比较。记录治疗前后的牙周参数,如牙龈退缩评分和牙根吸收情况。还对患者报告结局指标进行了调查。

结果

治疗后发现颊侧骨总体显著增加2.7±2.7%。根尖区域增加最多,为8.9±5.5%,而最冠方区域的骨膜未显著增加(1.2±2.7%)。未观察到诸如牙龈退缩或牙根吸收等不良事件。然而,有2例患者生物材料未完全整合,似乎被包裹。除手术当天外,疼痛程度和对乙酰氨基酚的消耗量与佩戴正畸矫治器后相当。

结论

在本研究的局限性内,压电切开联合使用隧道技术进行颊侧骨再生似乎能有效增加骨量,且未导致牙龈退缩。然而,有2例生物材料似乎被包裹,因此材料整合的可预测性值得质疑。ClinicalTrials.gov注册号:NCT03655938。

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