Minetti Elio, Gianfreda Francesco, Palermo Andrea, Bollero Patrizio
Department of Biomedical, Surgical, and Dental Science, University of Milan, 20122 Milan, Italy.
Department of Industrial Engineering, University of Rome "Tor Vergata", 00133 Rome, Italy.
Materials (Basel). 2022 Jun 18;15(12):4319. doi: 10.3390/ma15124319.
(1) Background: The phenomenon of ankylosis of the dental elements has led clinicians to think that properly treated dentin and cement may be a potential graft for alveolar ridge augmentation. Currently, there are no studies in the literature able to histomorphometrically compare the healing patterns of an autogenous dentin particulate graft with the association, or not, of resorbable membranes. The aim of this pilot study is to histologically compare bone after an alveolar ridge augmentation using an autogenous dentin particulate graft with and without a resorbable collagen membrane. (2) Methods: this clinical trial enrolled six patients with defects requiring bone augmentation. Two procedures were performed in all six adult human patients in order to perform a study-control study: in Group 1, a ridge augmentation procedure with an autogenous dentin particulate graft and a resorbable collagen membrane was performed, and, in Group 2, an alveolar ridge preservation without a membrane was performed at the same time (T0). At 4 months, a biopsy of the bone tissues was performed using a 4 mm trephine bur in order to perform a histomorphometric analysis. (3) Results: The histomorphometric analysis demonstrated that Group 1 presented 45% of bone volume, 38% of vital bone, and 7% of residual graft. On the contrary, membrane-free regenerative procedures demonstrated 37% of bone volume, 9% of vital bone, and 27% of non-resorbed graft. In all cases, the regenerated bone allowed the insertion of implants with a standard platform, and no early failures were recorded. (4) Conclusions: Autogenous dentin particulate grafts seem to work best when paired with a membrane.
(1) 背景：牙体组织粘连现象促使临床医生认为，经过适当处理的牙本质和牙骨质可能是用于牙槽嵴增量的潜在移植物。目前，文献中尚无研究能够从组织形态计量学角度比较自体牙本质颗粒移植物在联合或不联合可吸收膜情况下的愈合模式。本前瞻性研究的目的是从组织学角度比较使用自体牙本质颗粒移植物联合或不联合可吸收胶原膜进行牙槽嵴增量后的骨情况。(2) 方法：本临床试验纳入了6例需要进行骨增量的患者。为了进行研究对照研究，对所有6例成年患者均实施了两种操作：在第1组中，进行了自体牙本质颗粒移植物联合可吸收胶原膜的牙槽嵴增量手术；在第2组中，同时进行了不使用膜的牙槽嵴保存术（T0）。在4个月时，使用4mm环钻对骨组织进行活检，以进行组织形态计量分析。(3) 结果：组织形态计量分析表明，第1组的骨体积占45%，活性骨占38%，残余移植物占7%。相反，无膜再生手术的骨体积占37%，活性骨占9%，未吸收的移植物占27%。在所有病例中，再生骨均允许植入具有标准平台的种植体，且未记录到早期失败病例。(4) 结论：自体牙本质颗粒移植物与膜联合使用时效果似乎最佳。
