Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy -
Operative Unit of Dentistry, Azienda Unità Sanitaria Locale (AUSL), Ferrara, Italy -
Minerva Dent Oral Sci. 2023 Aug;72(4):176-184. doi: 10.23736/S2724-6329.23.04776-9. Epub 2023 Apr 17.
A recent systematic review failed to identify one approach for alveolar ridge preservation with superior outcomes. The present case series aimed to evaluate the dimensional changes of sites undergoing Biologically-oriented Alveolar Ridge Preservation (BARP).
The sockets were filled with a collagen sponge up to 4-5 mm from the most coronal extensions of the crest. Xenograft particles were placed to fill the coronal part. In cases with a compromised buccal/lingual bone, an additional collagen sponge was interposed between the residual cortical bone plate and the mucoperiosteal flap. A collagen sponge was placed to cover the graft.
The study population consisted in 10 extraction sites. Mean change in bone width and vertical ridge position as observed from BARP to re-entry for implant placement were 1.3 mm (14.4%) and 0.6 mm, respectively. The mean distance between buccal and lingual flap healing by secondary intention shifted from 4.9 mm immediately after BARP to 1.8 mm at 2 weeks. No marked differences in the dimensional changes of alveolar ridge were observed between sites with intact or deficient buccal bone plate. All implants were successfully loaded at 2-3 months after placement. In one case, bone augmentation was required.
The stratification of materials proposed in BARP-technique and the additional use of a resorbable device to stabilize graft particles at the buccal aspect provided the conditions for maintaining the ridge dimensions following tooth extraction comparable to the other technique of ARP, restricting the use of graft material to the most coronal portion of the socket.
最近的一项系统评价未能确定一种具有优越结果的牙槽嵴保存方法。本病例系列旨在评估接受生物导向性牙槽嵴保存（BARP）的部位的尺寸变化。
将胶原海绵填充到嵴最冠方延伸 4-5mm 的部位，将异种移植物颗粒放置在冠方部位填充。在颊/舌侧骨受损的情况下，在残余皮质骨板和黏膜骨膜瓣之间插入额外的胶原海绵。将胶原海绵放置以覆盖移植物。
研究人群包括 10 个拔牙部位。从 BARP 到植入物放置的再进入观察到骨宽度和垂直嵴位置的平均变化分别为 1.3mm（14.4%）和 0.6mm。颊侧和舌侧瓣二期愈合的平均距离从 BARP 后即刻的 4.9mm 转移到 2 周时的 1.8mm。颊侧骨板完整或缺失的部位牙槽嵴尺寸变化无明显差异。所有植入物在放置后 2-3 个月均成功加载。在一个病例中，需要进行骨增量。
BARP 技术中提出的材料分层和在颊侧使用可吸收装置来稳定移植物颗粒，为拔牙后维持与其他 ARP 技术相当的嵴尺寸提供了条件，将移植物材料的使用限制在牙槽窝的最冠方部分。
