Biomaterials Division, New York University College of Dentistry, New York, New York, USA.
Department of Dental Implants and Tissue Regeneration, Hygeia Hospital, Marousi, Greece.
J Oral Implantol. 2022 Dec 1;48(6):541-549. doi: 10.1563/aaid-joi-D-21-00012.
The aim of this study was to clinically evaluate the guided bone regeneration (GBR) potential of allograft, xenograft, and alloplastic materials in combination with resorbable membranes in extraction sockets. The qualitative and quantitative assessments of this prospective study were accomplished through histologic and histomorphometric analysis. Three experimental groups and 1 control group for comparison (n = 8) received either an allograft (human cancellous bone, freeze dried, Deutsches Institut für Zell und Gewebeersatz, Berlin, Germany), xenograft (BioOss, Geistlich Pharma AG, Wolhusen, Switzerland), or alloplast (biphasic calcium sulphate, Bondbone, MIS Implants Technologies Ltd., Charlotte, NC). The negative control group received no regenerative material. Tissue samples were then qualitatively and quantitatively evaluated as a function of percentage of new vital bone, graft particles content, soft tissue, and bone marrow over time. All 3 study groups presented bone volume suitable for the successful placement of a dental implant. The xenograft group yielded significantly less amount of vital bone compared with the allograft and alloplast groups. When comparing the percentage of residual graft particles, there was significantly greater amounts associated with the xenograft group in contrast to the allograft and alloplast groups. Similarly, a significantly increased amount of soft tissue percentage was observed within the xenograft group relative to all other groups. No significant differences were observed in the percentage of residual graft particles between the allograft and alloplast groups. There were also no significant differences detected in vital bone percentage between the allograft, alloplast, and control groups. When evaluating the bone marrow percentage, the only significant difference detected was between the xenograft and alloplast materials. Overall, no complications (ie, fever, malaise, purulence or fistula) were observed during the entirety of clinical trial among all patients. The greatest GBR potential was associated with the allograft material because of the greater degree of vital bone and the lowest percentage of residual graft particles. All studied bone substitute materials resulted in bone apposition for efficient use in alveolar ridge preservation procedures.
本研究旨在临床评估同种异体移植物、异种移植物和合成材料与可吸收膜结合在拔牙窝中引导骨再生（GBR）的潜力。通过组织学和组织形态计量学分析对这项前瞻性研究进行定性和定量评估。三个实验组和一个对照组（n = 8）分别接受同种异体移植物（冻干的德国细胞和组织替代物研究所，柏林，德国）、异种移植物（BioOss，Geistlich Pharma AG，Wolhusen，瑞士）或合成材料（双相硫酸钙，Bondbone，MIS Implants Technologies Ltd.，夏洛特，北卡罗来纳州）。阴性对照组未接受任何再生材料。然后根据新的活骨百分比、移植物颗粒含量、软组织和骨髓的时间，对组织样本进行定性和定量评估。所有 3 个研究组的骨量均适合成功植入牙种植体。与同种异体移植物和合成材料组相比，异种移植物组产生的活骨量明显较少。当比较残留移植物颗粒的百分比时，与同种异体移植物和合成材料组相比，异种移植物组中残留的移植物颗粒明显更多。同样，与其他所有组相比，在异种移植物组中观察到软组织百分比显著增加。同种异体移植物和合成材料组之间残留移植物颗粒百分比无显著差异。同种异体移植物、合成材料和对照组之间的活骨百分比也无显著差异。在评估骨髓百分比时，唯一发现的显著差异是异种移植物和合成材料之间的差异。总体而言，在所有患者的整个临床试验过程中，没有观察到任何并发症（即发热、不适、脓性分泌物或瘘管）。由于活骨程度较高和残留移植物颗粒百分比最低，同种异体移植物材料与最大的 GBR 潜力相关。所有研究的骨替代材料均导致骨沉积，可有效用于牙槽嵴保存程序。
