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有意暴露不可吸收的d-聚四氟乙烯膜或引导骨再生治疗种植体支持修复的拔牙后牙槽骨缺损后骨的组织形态计量学:一项初步随机对照试验。

Histomorphometry of Bone after Intentionally Exposed Non-Resorbable d-PTFE Membrane or Guided Bone Regeneration for the Treatment of Post-Extractive Alveolar Bone Defects with Implant-Supported Restorations: A Pilot Randomized Controlled Trial.

作者信息

Luongo Roberto, Tallarico Marco, Canciani Elena, Graziano Daniele, Dellavia Claudia, Gargari Marco, Ceruso Francesco Mattia, Melodia Dario, Canullo Luigi

机构信息

Arthur Ashman Department of Periodontology and Implant Dentistry, NYU College of Dentistry, New York, NY 10010, USA.

Independent Researcher, 70100 Bari, Italy.

出版信息

Materials (Basel). 2022 Aug 24;15(17):5838. doi: 10.3390/ma15175838.

Abstract

: The aim of the present study was to investigate quantitative histological examination of bone reconstructed with non-resorbable high-density polytetrafluoroethylene membrane (d-PTFE), left intentionally exposed in post extraction sockets grafted with anorganic bone material, and removed after four weeks, versus extraction and guided bone regeneration (GBR), performed two months later. : This study was designed as a multicenter randomized controlled trial of parallel-group design. Patients were selected and consecutively treated in three centers in Italy. Patients randomly received intentionally exposed non-resorbable d-PTFE membrane (group A), or guided bone regeneration (group B), to treat post-extractive alveolar bone defects with implant-supported restorations. Outcomes were: the implant failure, any mechanical and biological complications, patient satisfaction, and qualitative and histomorphometric evaluation of the collected bone samples. : Eighteen patients were consecutively enrolled in the trial. Of these, six out of 18 patients were male. All the included patients were treated according to the allocated interventions, and no drop out occurred. No implant failure and no complications were experienced, and all the patients were fully satisfied with the function and aesthetic of their implant-supported restoration, without difference between groups. Morphological analysis revealed no sign of tissue reaction, such as fibrosis or necrosis. Regenerated bone was well mineralized in both groups, but it seemed more mature in group B than in group A. Three samples showed a minimal number of lymphocytes. Several blood vessels of small size occupied the medullary spaces, where the tissue resulted in more maturity, indicating the activity of the tissue in progress. The histomorphometric evaluation showed no statistically significant differences in the tissue volume fractions between the two groups of patients. : With the limitation of the present study, buccal plate reconstruction with an intentionally exposed non-resorbable membrane is an effective and easy procedure for regenerating a resorbed buccal bone plate, reducing the need for guided bone regeneration.

摘要

本研究的目的是调查用不可吸收的高密度聚四氟乙烯膜(d-PTFE)重建骨组织的定量组织学检查结果。该膜在植入无机骨材料的拔牙窝中故意暴露,四周后取出,与两个月后进行的拔牙并引导骨再生(GBR)进行对比。

本研究设计为平行组设计的多中心随机对照试验。在意大利的三个中心选择患者并进行连续治疗。患者随机接受故意暴露的不可吸收d-PTFE膜(A组)或引导骨再生(B组),以治疗种植体支持修复的拔牙后牙槽骨缺损。观察指标包括:种植体失败情况、任何机械和生物学并发症、患者满意度以及对采集的骨样本进行定性和组织形态计量学评估。

共有18名患者连续纳入该试验。其中,18名患者中有6名男性。所有纳入患者均按照分配的干预措施进行治疗,无失访情况。未发生种植体失败和并发症,所有患者对种植体支持修复的功能和美观均完全满意,两组之间无差异。形态学分析未发现组织反应迹象,如纤维化或坏死。两组再生骨均矿化良好,但B组似乎比A组更成熟。三个样本显示淋巴细胞数量极少。几个小血管占据了骨髓腔,此处组织更成熟,表明组织正在进行活跃的活动。组织形态计量学评估显示,两组患者的组织体积分数无统计学显著差异。

鉴于本研究的局限性,用故意暴露的不可吸收膜进行颊板重建是再生吸收的颊骨板的一种有效且简便的方法,减少了引导骨再生的需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b199/9457509/e4c7eb5e620f/materials-15-05838-g001.jpg

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