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两种生物材料与自体骨移植混合用于垂直骨增量的对比分析:一项人体组织形态计量学研究。

Comparative analysis of two biomaterials mixed with autogenous bone graft for vertical ridge augmentation: A histomorphometric study in humans.

机构信息

Department of Implant Dentistry, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, Brazil.

Researcher of Oral Basic Research Unit -UIBO, School of Dentistry, El Bosque University, Bogotá, Colombia.

出版信息

Clin Implant Dent Relat Res. 2022 Oct;24(5):709-719. doi: 10.1111/cid.13124. Epub 2022 Aug 2.

Abstract

BACKGROUND

The vertical increase of the alveolar ridge dimension using allograft or xenograft mixed with autogenous bone graft and covered by a nonabsorbable high-density polytetrafluoroethylene (d-PTFE) membrane is well documented in the literature.

PURPOSE

The aim of this study was to assess vital mineralized tissue formation in vertical ridge augmentation (VRA) procedures using autogenous bone chips mixed either with an allograft or a xenograft.

METHODS

This prospective clinical trial recruited 16 partially edentulous patients to undergo vertical ridge augmentation in one or more sites, making up a total of 24 samples for histological evaluation. Patients were sequentially stratified into Group A (treated with a freeze-dried bone allograft [FDBA] mixed with autogenous bone) or to Group B (treated with a bovine xenograft mixed with autogenous bone). Histological samples were analyzed according to the biomaterial used for VRA. Histological samples were obtained on the same day of membrane removal and implant placement.

RESULTS

Thirty-three implants were placed in 16 sites of regenerated bone via VRA, 13 patients with ridge augmentation in the posterior mandible, and 3 patients with VRA in the anterior maxilla. Group A (FDBA + autogenous) and Group B (xenograft + autogenous) showed a percent vital mineralized tissue (VMT) area of 67.64 ± 16.84 and 60.93 ± 18.25, respectively. A significant difference between the two biomaterials was not observed.

CONCLUSION

When mixed with autogenous bone, either allografts or xenografts may provide a successful augmentation. Either mixture could serve as reliable alternative in VRA for obtaining a high percentage of VMT.

摘要

背景

异体或异种移植物与自体骨移植混合,并覆盖不可吸收的高密度聚四氟乙烯(d-PTFE)膜,可增加牙槽嵴的垂直高度,这在文献中有充分的记载。

目的

本研究旨在评估使用自体骨屑与同种异体或异种骨混合进行垂直牙槽嵴增量(VRA)手术时,活的矿化组织的形成情况。

方法

这项前瞻性临床试验招募了 16 名部分无牙患者,在一个或多个部位进行垂直牙槽嵴增量,共有 24 个样本用于组织学评估。患者按顺序分层到 A 组(用冻干骨同种异体移植物[FDBA]与自体骨混合治疗)或 B 组(用牛异种移植物与自体骨混合治疗)。根据用于 VRA 的生物材料对组织学样本进行分析。组织学样本是在同一天去除膜并放置植入物时获得的。

结果

通过 VRA 在 16 个再生骨部位共植入 33 个种植体,13 名患者在后下颌进行牙槽嵴增量,3 名患者在前上颌进行 VRA。A 组(FDBA+自体)和 B 组(异种移植物+自体)的活矿化组织(VMT)面积百分比分别为 67.64±16.84 和 60.93±18.25。两种生物材料之间没有观察到显著差异。

结论

与自体骨混合时,同种异体移植物或异种移植物都可能提供成功的增量。这两种混合物都可以作为 VRA 中获得高比例 VMT 的可靠替代物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c4bb/9804607/bf6235840dfe/CID-24-709-g001.jpg

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