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在磨牙部位进行的 Ridge 保存术:比较异种移植物与矿化冻干骨同种异体移植物:一项随机临床试验。

Ridge preservation in molar sites comparing xenograft versus mineralized freeze-dried bone allograft: A randomized clinical trial.

机构信息

Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain.

出版信息

Clin Oral Implants Res. 2022 May;33(5):511-523. doi: 10.1111/clr.13911. Epub 2022 Mar 14.

Abstract

OBJECTIVES

The main objective of the study was to compare the dimensional ridge changes and the histological composition after the use of an allograft or xenograft and a resorbable membrane in ridge preservation in molar sites and to evaluate the influence of bone plate thickness on dimensional changes and the need of lateral sinus augmentation following ridge preservation.

MATERIALS AND METHODS

Twenty-four patients in need of maxillary or mandibular first or second molar extraction and subsequent implant placement were included and randomly assigned to a group; allograft or xenograft, plus a collagen membrane. Cone-beam computed tomographies were obtained after molar extraction and after 5 months. A bone sample was harvested at the time of implant placement and analyzed by histomorphometry.

RESULTS

Bone ridge was reduced significantly. Major changes in width occurred at 1 mm from the bone crest (-2.93 ± 2.28 mm) (p = .0002), while in height, the greatest reduction occurred at the buccal area (-1.97 ± 2.21 mm) (p = .0006). However, differences between groups were not significant. Thicker buccal bone plates exhibited less bone remodeling, while histologically, both biomaterials resulted in similar tissue composition. The resulting available bone height in the implant site measured 7.30 ± 3.53 mm initially and 6.8 ± 3.61 mm after 5 months which allowed implant placement without the need for lateral sinus augmentation in all cases. Still, 55% of the preserved areas needed transcrestal sinus lift.

CONCLUSION

Ridge preservation in molar sites using a mineralized allograft or xenograft provides similar dimensional and histomorphometrical results after 5 months.

摘要

目的

本研究的主要目的是比较使用同种异体移植物或异种移植物和可吸收膜进行磨牙部位牙槽嵴保存时的脊状变化和组织学组成,并评估骨板厚度对尺寸变化的影响以及在牙槽嵴保存后是否需要进行外侧窦增强。

材料和方法

纳入 24 名需要上颌或下颌第一或第二磨牙拔除和随后植入的患者,并随机分配到一组;同种异体移植物或异种移植物,加胶原膜。在磨牙拔除后和 5 个月后获取锥形束计算机断层扫描。在植入物放置时采集骨样本,并通过组织形态计量学进行分析。

结果

牙槽嵴明显减少。宽度的主要变化发生在距牙槽嵴 1 毫米处(-2.93±2.28 毫米)(p=0.0002),而在高度方面,颊侧的最大减少发生在(-1.97±2.21 毫米)(p=0.0006)。然而,两组之间的差异没有统计学意义。较厚的颊侧骨板表现出较少的骨重塑,而组织学上,两种生物材料均导致相似的组织组成。植入部位最初的可用骨高度为 7.30±3.53 毫米,5 个月后为 6.8±3.61 毫米,所有情况下均无需进行外侧窦增强即可植入。尽管如此,55%的保存区域需要经牙槽嵴窦提升。

结论

在磨牙部位使用矿化同种异体移植物或异种移植物进行牙槽嵴保存,在 5 个月后可获得相似的尺寸和组织形态计量学结果。

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