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使用自体全牙与脱矿牙本质移植物进行牙槽嵴保存:一项随机对照临床试验。

Alveolar ridge preservation using autogenous whole-tooth versus demineralized dentin grafts: A randomized controlled clinical trial.

机构信息

Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt.

Oral and Maxillofacial Pathology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt.

出版信息

Clin Oral Implants Res. 2021 May;32(5):539-548. doi: 10.1111/clr.13722. Epub 2021 Mar 1.

Abstract

OBJECTIVE

The objective of this randomized controlled trial was to evaluate the radiographic changes and histologic healing following alveolar ridge preservation (ARP) using autogenous whole tooth (AWTG), test group, versus autogenous demineralized dentin graft (ADDG), control group.

MATERIAL AND METHODS

Twenty non-molar teeth indicated for extraction were randomized into two groups (n = 10/group). Extracted teeth were prepared into AWTG or ADDG (0.6N HCl; 30 min), inserted into extraction sockets and covered by collagen membranes. Cone-beam computed tomography (CBCT) scans at baseline and six months were compared to assess ridge-dimensional changes. At six months, bone biopsies of engrafted sites were harvested and analyzed histomorphometrically.

RESULTS

All sites healed uneventfully. Reduction was 0.85 ± 0.38 mm and 1.02 ± 0.45 mm in ridge width, 0.61 ± 0.20 mm and 0.72 ± 0.27 mm in buccal and 0.66 ± 0.31 mm and 0.56 ± 0.24 mm in lingual ridge height for the AWTG and ADDG group, respectively (p > .05). Histologically, no inflammatory reactions were noticeable and all samples showed new bone formation. Qualitatively, graft-bone amalgamations were more pronounced in ADDG samples. Histomorphometrically, new bone, graft remnants and soft tissue occupied 37.55% ± 8.94%, 17.05% ± 5.58% and 45.4% ± 4.06% of the areas in the AWTG group and 48.4% ± 11.56%, 11.45% ± 4.13% and 40.15% ± 7.73% in the ADDG group of the examined areas, respectively (p > .05).

CONCLUSIONS

AWTG and ADDG are similarly effective in ARP. Yet, histologically ADDG seems to demonstrate better graft remodeling, integration and osteoinductive properties.

摘要

目的

本随机对照试验的目的是评估使用自体全牙(AWTG)的牙槽嵴保存(ARP)后的影像学变化和组织学愈合情况,实验组,与自体脱矿牙本质移植物(ADDG),对照组。

材料和方法

20 颗因拔牙而被认为是恒牙的牙齿被随机分为两组(每组 n=10)。拔牙后制备成 AWTG 或 ADDG(0.6N HCl;30 分钟),插入拔牙窝并用胶原膜覆盖。在基线和 6 个月时进行锥形束计算机断层扫描(CBCT)扫描,以评估牙槽嵴尺寸变化。在 6 个月时,采集移植部位的骨活检并进行组织形态计量学分析。

结果

所有部位均愈合良好。牙槽嵴宽度的减少量分别为 0.85±0.38mm 和 1.02±0.45mm,颊侧分别为 0.61±0.20mm 和 0.72±0.27mm,舌侧分别为 0.66±0.31mm 和 0.56±0.24mm,在 AWTG 和 ADDG 组中(p>.05)。组织学上,未观察到炎症反应,所有样本均显示有新骨形成。定性分析,ADDG 样本中移植物-骨融合更为明显。组织形态计量学上,新骨、移植物残余物和软组织分别占 AWTG 组检查区域的 37.55%±8.94%、17.05%±5.58%和 45.4%±4.06%,ADDG 组检查区域的 48.4%±11.56%、11.45%±4.13%和 40.15%±7.73%(p>.05)。

结论

AWTG 和 ADDG 在 ARP 中同样有效。然而,组织学上 ADDG 似乎显示出更好的移植物重塑、整合和骨诱导特性。

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