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自体骨块与脱细胞异种骨块在萎缩牙槽嵴重建中的比较:一项非劣效性随机临床试验。

Autogenous bone block versus collagenated xenogeneic bone block in the reconstruction of the atrophic alveolar ridge: A non-inferiority randomized clinical trial.

机构信息

Discipline of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil.

Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland.

出版信息

J Clin Periodontol. 2022 Nov;49(11):1158-1168. doi: 10.1111/jcpe.13701. Epub 2022 Jul 26.

Abstract

AIM

To compare the efficacy of equine-derived collagenated xenogeneic bone blocks (CXBB) and autogenous bone block (ABB) for lateral alveolar ridge augmentation and two-stage implant placement.

MATERIALS AND METHODS

Sixty-four patients with tooth gaps up to four teeth and atrophic alveolar ridges with ≤4 mm were randomly assigned to lateral augmentation using CXBB or ABB. Lateral bone thickness (LBT) was measured 2 mm below the alveolar crest at augmentation surgery and 30 weeks later at implant placement. Implant-related outcomes, adverse events, surgery duration, pain sensation, analgesic consumption, and oral health-related quality of life were also assessed. Data were analysed using Fisher's exact, Mann-Whitney, and Wilcoxon signed-rank tests.

RESULTS

At 30 weeks, the median change in LBT amounted to 2.90 (CXBB) and 3.00 (ABB), respectively. Secondary endpoints demonstrated similar results for CXBB and ABB in terms of possibility to place an implant, need to perform a secondary bone augmentation at implant placement and rate of complications. Early implant failure was 20% for CXBB and 10% for ABB, with no difference between the groups. Pain scores and post-operative consumption of analgesics were significantly lower in the CXBB group than in the ABB group, especially during the first days post-surgery.

CONCLUSIONS

CXBB is non-inferior to ABB for horizontal alveolar ridge augmentation and two-stage implant placement.

摘要

目的

比较马源胶原异种骨块(CXBB)和自体骨块(ABB)在侧向牙槽嵴增量和二期种植体植入中的疗效。

材料和方法

将 64 名牙间隙达 4 颗且牙槽嵴萎缩≤4 mm 的患者随机分为 CXBB 或 ABB 侧向骨增量组。在骨增量手术和 30 周后种植体植入时,测量牙槽嵴下 2 mm 的侧向骨厚度(LBT)。还评估了与种植体相关的结果、不良事件、手术持续时间、疼痛感觉、镇痛药消耗和口腔健康相关的生活质量。使用 Fisher 确切检验、Mann-Whitney 和 Wilcoxon 符号秩检验对数据进行分析。

结果

30 周时,LBT 的中位数变化分别为 2.90(CXBB)和 3.00(ABB)。次要终点显示,CXBB 和 ABB 在植入体的可植入性、植入时是否需要进行二次骨增量以及并发症发生率方面具有相似的结果。CXBB 的早期种植体失败率为 20%,ABB 为 10%,两组之间无差异。CXBB 组的疼痛评分和术后镇痛药消耗明显低于 ABB 组,尤其是在手术后的头几天。

结论

CXBB 对于水平牙槽嵴增量和二期种植体植入与 ABB 具有非劣效性。

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