临床、影像学和组织学评估在 EDS 3-4 类缺损中使用自体牙源性颗粒移植物进行牙槽嵴保存。
Clinical, radiographical and histological evaluation of alveolar ridge preservation with an autogenous tooth derived particulate graft in EDS class 3-4 defects.
机构信息
Department of Periodontology, Semmelweis University, Szentkirályi street 47., Budapest, 1088, Hungary.
Scientific Students' Associations Student, Semmelweis University, Budapest, Hungary.
出版信息
BMC Oral Health. 2021 Feb 11;21(1):63. doi: 10.1186/s12903-021-01429-y.
BACKGROUND
The shrinkage of alveolar bone dimensions after tooth extraction is a well-known issue. This clinical phenomenon poses a challenge for clinicians aiming at implant-prosthetic treatment. BonMaker ATB is a novel autogenous bone grafting material, produced by the mechanical and chemical processing of natural teeth. This pilot case report aims at providing a clinical, radiographical, and histological evaluation of the safety and efficacy of Bonmaker ATB powder in the treatment of EDS class 3-4 postextraction sockets with alveolar ridge preservation.
METHODS
A total of 9 teeth were extracted from 5 patients. The extracted teeth were prepared immediately with the Bonmaker device. The extraction sockets were filled up with ATB powder. Six months after extraction, standardized intraoral x-rays and CBCT scans were performed. Re-entry was performed under local anaesthesia. Core biopsies were harvested for histological analysis and implants were placed.
RESULTS
Horizontal alveolar dimension loss occurred, even though ARP was performed, but the horizontal shrinkage was moderate. Vertical dimensions did not show loss of volume, but increased defect fill. Core biopsies showed ATB particles surrounded by newly formed bone and connective tissue. According to histomorphometric analysis, the harvested samples contained 56% of newly formed bone on average, and only a mean of 7% of non-remodelled ATB material was observed.
CONCLUSION
The preliminary clinical, radiographical, and histological results of Bonmaker autogenous tooth graft therapy indicate that ATB may be safely and successfully used as a grafting material for ARP. Optimal graft incorporation and histologically proven effective remodelling, as well as uneventful wound healing support the clinical application of ATB to minimize post-extraction hard tissue loss. Further research is needed to exploit the full potential of ATB and to evaluate the long-term peri-implant hard and soft tissue stability of ATB-treated post-extraction sites.
背景
拔牙后牙槽骨尺寸的收缩是一个众所周知的问题。这一临床现象对旨在进行种植修复治疗的临床医生构成了挑战。BonMaker ATB 是一种新型的自体骨移植材料，通过对天然牙齿进行机械和化学处理而制成。本病例报告旨在对 Bonmaker ATB 粉末在治疗 EDS 3-4 类拔牙后牙槽嵴保存的拔牙窝中的安全性和有效性进行临床、放射学和组织学评估。
方法
从 5 名患者中总共拔出 9 颗牙齿。用 Bonmaker 设备立即对拔出的牙齿进行准备。用 ATB 粉末填充拔牙窝。拔牙后 6 个月，进行标准化的口腔内 X 光和 CBCT 扫描。在局部麻醉下进行再进入。采集核心活检进行组织学分析并植入种植体。
结果
尽管进行了 ARP，但仍发生了水平牙槽骨尺寸损失，但是水平收缩程度适中。垂直尺寸没有出现体积损失，反而增加了缺陷填充。核心活检显示 ATB 颗粒被新形成的骨和结缔组织包围。根据组织形态计量学分析，所采集的样本平均含有 56%的新形成骨，仅观察到平均 7%的未重塑的 ATB 材料。
结论
Bonmaker 自体牙移植治疗的初步临床、放射学和组织学结果表明，ATB 可安全且成功地用作 ARP 的移植材料。最佳的移植物结合和组织学上证明的有效重塑，以及无并发症的伤口愈合支持 ATB 的临床应用，以最大程度地减少拔牙后硬组织损失。需要进一步研究以充分发挥 ATB 的潜力，并评估 ATB 治疗拔牙后位点的长期种植体周围软硬组织稳定性。
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