Friedmann Anton, Meskeleviciene Viktorija, Yildiz Mehmet Selim, Götz Werner, Park Jung Chul, Fischer Kai R
Department of Periodontology, Witten/Herdecke University Faculty of Health, Witten, Germany.
Department of Periodontology, Altınbaş University Faculty of Dentistry, Istanbul, Turkey.
J Periodontal Implant Sci. 2020 Dec;50(6):406-417. doi: 10.5051/jpis.2000400020.
This study investigated whether the placement of ribose cross-linked collagen (RCLC) membranes without primary soft tissue closure predictably resulted in sufficient alveolar ridge preservation in contained and non-contained extraction sockets.
Membranes were positioned across extraction sockets, undermining full-thickness flaps, and the gingival margins were fixed by double-interrupted sutures without crossed horizontal mattress sutures for 1 week. In non-contained sockets, a bone substitute was used to support the membrane within the bony envelope. Radiographs and clinical images obtained 4 months later were analyzed by ImageJ software using non-parametric tests.
In 18 patients, 20 extraction sockets healed uneventfully and all sites received standard-diameter implants (4.1, 4.8, or 5.0 mm) without additional bone augmentation. Soft tissues and the muco-gingival border were well maintained. A retrospective analysis of X-rays and clinical photographs showed non-significant shrinkage in the vertical and horizontal dimensions (=0.575 and =0.444, respectively). The new bone contained vital bone cells embedded in mineralized tissues.
Within the limitations of this pilot study, open healing of RCLC membranes may result in sufficient bone volume for implant placement without additional bone augmentation in contained and non-contained extraction sockets.
本研究调查了在不进行初期软组织缝合的情况下放置核糖交联胶原(RCLC)膜,是否能在有牙槽窝和无牙槽窝的拔牙创中可预测地实现足够的牙槽嵴保存。
将膜置于拔牙创上,掀起全厚瓣,牙龈边缘用双间断缝合固定,不使用交叉水平褥式缝合,持续1周。在无牙槽窝的创口内,使用骨替代物在骨壳内支撑膜。4个月后获得的X线片和临床图像通过ImageJ软件使用非参数检验进行分析。
18例患者的20个拔牙创愈合良好,所有部位均植入标准直径种植体(4.1、4.8或5.0mm),无需额外植骨。软组织和龈黏膜边界保持良好。对X线片和临床照片的回顾性分析显示,垂直和水平方向的萎缩不显著(分别为=0.575和=0.444)。新骨中含有嵌入矿化组织中的活骨细胞。
在本初步研究的局限性内,RCLC膜开放愈合可能在有牙槽窝和无牙槽窝的拔牙创中产生足够的骨量用于种植体植入,而无需额外植骨。