Kollek Nathalie Jeannette, Pérez-Albacete Martínez Carlos, Granero Marín José Manuel, Maté Sánchez de Val José Eduardo
Department of Implant Dentistry, International Dental Research Institute, Catholic University San Antonio of Murcia (UCAM), Murcia, Spain.
Department of Integrated Clinic for Adults, International Dental Research Institute, Catholic University San Antonio of Murcia, Murcia, Spain.
Eur J Dent. 2023 Jul;17(3):727-734. doi: 10.1055/s-0042-1753453. Epub 2022 Oct 4.
This study was performed to evaluate the clinical, radiographic, and histomorphometric outcomes of novel bone grafting materials and dental membranes and to compare the results with current data from the literature.
New synthetic bone substitutes, consisting of biphasic calcium phosphate in the ratio of 60% hydroxyapatite and 40% β-tricalcium phosphate, were applied in bony defects and covered by either a novel synthetic poly(lactic-co-glycolic) acid (PLGA) or porcine collagen membrane. A sample of 51 biomaterials was placed in a total of 20 patients during different surgical protocols. Implants were simultaneously inserted, and in the case of sinus floor elevations 6 months later. Pre- and postoperative cone-beam computed tomographies were taken. Bone biopsies were harvested from augmented sides and processed for histomorphometric evaluation.
Averages and ranges were calculated for the percentage of newly formed bone, residual biomaterial, and connective tissue. Data were submitted to analyze the radiological mean differences in length, width, and density. Paired -tests were deployed for the analysis of differences within each group between the baseline (preoperative) and the final (postoperative) measurements.
The mean bone gain in length and width were 0.96 ± 3.33 mm (+27.59%) and 1.22 ± 1.87 mm (+30.48%), respectively. The bone density was increased by a factor of 4, reaching an average of 387.47 ± 328.86 HU. Histomorphometric evaluations revealed new bone formation of 41.44 ± 5.37%, residual biomaterial of 24.91 ± 7.31%, and connective tissue of 33.64 ± 4.81%. The mean healing period was 8.32 ± 3.00 months.
Data from this study confirmed the suitability of the tested materials in dental surgery. The biomaterials may be recommended for various clinical procedures. A satisfactory level of increase of new bone was reported in augmented sides. No significant differences were observed between the tested membranes. PLGA membranes might be superior to collagen membranes for their easier handling.
本研究旨在评估新型骨移植材料和牙膜的临床、影像学及组织形态计量学结果,并将结果与文献中的现有数据进行比较。
新型合成骨替代物由比例为60%羟基磷灰石和40%β-磷酸三钙的双相磷酸钙组成,应用于骨缺损处,并用新型合成聚乳酸-乙醇酸共聚物(PLGA)膜或猪胶原膜覆盖。在不同的手术方案中,共20例患者植入了51种生物材料样本。同时植入种植体,在窦底提升的情况下于6个月后进行。术前和术后均进行锥形束计算机断层扫描。从植骨侧采集骨活检样本并进行组织形态计量学评估。
计算新形成骨、残余生物材料和结缔组织百分比的平均值及范围。提交数据以分析长度、宽度和密度的放射学平均差异。采用配对t检验分析每组基线(术前)和最终(术后)测量值之间的差异。
长度和宽度的平均骨增量分别为0.96±3.33mm(+27.59%)和1.22±1.87mm(+30.48%)。骨密度增加了4倍,平均达到387.47±328.86HU。组织形态计量学评估显示新骨形成率为41.44±5.37%,残余生物材料率为24.91±7.31%,结缔组织率为33.64±4.81%。平均愈合期为8.32±3.00个月。
本研究数据证实了所测试材料在牙科手术中的适用性。这些生物材料可推荐用于各种临床操作。据报道,植骨侧新骨增加水平令人满意。所测试的膜之间未观察到显著差异。PLGA膜因其操作更简便可能优于胶原膜。