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使用和不使用透明质酸进行侧向引导骨再生后的牙槽嵴改变:一项进行形态计量学和组织形态计量学评估的前瞻性随机试验

Alveolar ridge alterations after lateral guided bone regeneration with and without hyaluronic acid: a prospective randomized trial with morphometric and histomorphometric evaluation.

作者信息

Kauffmann Frederic, Fickl Stefan, Sculean Anton, Fischer Kai R, Friedmann Anton

出版信息

Quintessence Int. 2023 Oct 19;54(9):712-722. doi: 10.3290/j.qi.b4171703.

Abstract

OBJECTIVE

To clinically and histologically evaluate the potential effect of a cross-linked, high molecular weight hyaluronic acid (xHyA) on the outcomes of guided bone regeneration performed with a demineralized bovine bone mineral (DBBM) covered with a natural collagen membrane.

METHOD AND MATERIALS

Eleven patients (eight females and three males, mean age 53 years) with a total of 27 surgical sites were treated. Treatments were performed with either DBBM and natural collagen membrane fixed with tacks (group A) or DBBM mixed with xHyA and subsequently covered with natural collagen membrane (group B). Clinical evaluations were made at baseline (T1), immediately after guided bone regeneration (T2), and at the time of implant placement (T3). Additionally, at the time of implant placement, core biopsies were retrieved and submitted for histologic analysis.

RESULTS

Healing was uneventful in all cases. At 6 months, group B revealed a statistically significantly higher crestal ridge dimension compared to group A (P = .007). The histologic analysis revealed a tendency for greater mineralized tissue formation in group B compared to group A (67.5% versus 41.6%) and contained a higher amount of new bone (37.2%) and less DBBM residues (20.9%) than group A (12.8% new bone and 28.8% DBBM residues, respectively).

CONCLUSIONS

Within their limits, the present data indicate that, during guided bone regeneration with natural collagen membrane, the combination of DBBM and xHyA may improve the quality and quantity of bone formed with DBBM alone.

摘要

目的

从临床和组织学角度评估交联高分子量透明质酸(xHyA)对用天然胶原膜覆盖的脱矿牛骨矿物质(DBBM)进行引导骨再生效果的潜在影响。

方法和材料

对11例患者(8名女性和3名男性,平均年龄53岁)共27个手术部位进行治疗。治疗方法为使用用大头钉固定的DBBM和天然胶原膜(A组)或DBBM与xHyA混合后再覆盖天然胶原膜(B组)。在基线(T1)、引导骨再生后即刻(T2)以及植入种植体时(T3)进行临床评估。此外,在植入种植体时,获取核心活检组织并进行组织学分析。

结果

所有病例愈合均顺利。6个月时,B组的牙槽嵴尺寸在统计学上显著高于A组(P = 0.007)。组织学分析显示,与A组相比,B组有形成更多矿化组织的趋势(67.5%对41.6%),且新骨量更高(37.2%),DBBM残留量更少(20.9%),而A组新骨量为12.8%,DBBM残留量为28.8%。

结论

在本研究的局限性范围内,目前的数据表明,在用天然胶原膜进行引导骨再生过程中,DBBM与xHyA联合使用可能会改善单独使用DBBM时形成的骨的质量和数量。

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