Abo-El-Saad M M, Melek L N F, Abdel Fattah H S, Ayad S S
Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
Int J Oral Maxillofac Surg. 2023 Oct;52(10):1090-1096. doi: 10.1016/j.ijom.2023.01.010. Epub 2023 Feb 2.
After tooth extraction, alveolar bone resorption and labial bone plate thinning occur due to the lack of periodontal ligaments. The socket shield method was developed to preserve the alveolar ridge. A split-mouth study was performed in which eight patients were treated using alloplast with socket shield on one side (alloplast group, control) and autogenous dentin graft with socket shield on the contralateral side (dentin group, test). After 3 months, a trephine bone core was collected from all sites and evaluated by histological, histomorphometric, and radiographic analysis. Thin bony trabeculae were formed surrounding the residual alloplast, while thicker trabeculae of bone formed and fused to the autogenous dentin. The percentage of newly formed bone was significantly higher in the dentin group when compared to the alloplast group (P = 0.020). Radiographically, there was no significant difference in the mean percentage increase in bone density from preoperative to post-grafting between the two groups. Moreover, when comparing the change in labial bone level from preoperative to 3 months post-grafting between the two groups, there was no significant difference. The autogenous dentin graft combined with socket shield could be a promising technique for socket preservation.
拔牙后,由于缺乏牙周韧带,会发生牙槽骨吸收和唇侧骨板变薄。牙槽窝保护法就是为保留牙槽嵴而研发的。进行了一项双侧对照研究,8名患者一侧使用带有牙槽窝保护的异体材料治疗(异体材料组,对照组),对侧使用带有牙槽窝保护的自体牙本质移植治疗(牙本质组,试验组)。3个月后,从所有部位采集环钻骨芯,并通过组织学、组织形态计量学和影像学分析进行评估。残留的异体材料周围形成了薄的骨小梁,而较厚的骨小梁形成并与自体牙本质融合。与异体材料组相比,牙本质组新形成骨的百分比显著更高(P = 0.020)。影像学上,两组从术前到移植后骨密度平均增加百分比无显著差异。此外,比较两组从术前到移植后3个月唇侧骨水平的变化,也无显著差异。自体牙本质移植联合牙槽窝保护可能是一种很有前景的牙槽窝保存技术。