Vuylsteke Fauve, Cosyn Jan, Tytgat Manon, Eghbali Aryan
Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Oral Health Sciences, Ghent University, C. Heymanslaan 10, B-9000 Ghent, Belgium.
Private Practice Orthoparocare, Mankevosstraat 5, B-1860 Meise, Belgium.
J Clin Med. 2023 Jun 29;12(13):4372. doi: 10.3390/jcm12134372.
(1) Background: Use of Terra-Cortril may reduce pain and discomfort after tooth extraction. It is widely used among dentists, especially for third molar extraction and for treatment of dry socket. Only few case reports described unsuccessful healing with formation of myospherulosis. (2) Aim: The primary objective of this retrospective cohort study was to compare the occurrence of unsuccessful healing between extraction sockets locally treated with Terra-Cortril (TC) (exposure cohort) and extraction sockets subjected to unassisted healing (non-exposure cohort). The assessment of the three-dimensional morphology of the bone was a secondary objective. (3) Material and methods: The records of patients who had one or more extractions between 1 January 2020 and 1 July 2021 followed by implant placement in one private practice were retrieved and data were extracted. At the time of implant placement, practitioners established, both clinically and radiographically, if the healing was successful or unsuccessful. Explanatory demographic as well as clinical variables were extracted from patient files, checked and supplemented by contacting patients in cases of missing data. (4) Results: 69 patients were included who had, in total, 99 extractions. The exposure cohort included 55 sites, while the non-exposure cohort included 44 sites. A total of 56 sites demonstrated successful healing, and 53 showed unsuccessful healing. The regression model identified TC as a significant predictor ( = 0.014) for unsuccessful healing with an odds ratio of 2.86. Sites treated with Terra-Cortril had a significantly greater bone defect at level -1 mm, level -3 mm, and level -5 mm from the bone crest, and significantly greater maximal vertical and horizontal bone defects. At sites where Terra-Cortril was used, significantly more surgical consequences were reported (70.91% vs. 18.18%, < 0.001). (5) Conclusions: fresh extraction sockets treated with Terra-Cortril increased the likelihood of unsuccessful healing with an odds ratio of 2.86. The greater defect size leads to significantly more limitations when planning implants at sites previously treated with TC.
(1) 背景：使用特罗皮质醇（Terra-Cortril）可能会减轻拔牙后的疼痛和不适。它在牙医中广泛使用，尤其是用于拔除第三磨牙和治疗干槽症。仅有少数病例报告描述了愈合失败并形成了球状体病。(2) 目的：这项回顾性队列研究的主要目的是比较局部使用特罗皮质醇（TC）治疗的拔牙创口（暴露队列）和自然愈合的拔牙创口（非暴露队列）愈合失败的发生率。评估骨的三维形态是次要目的。(3) 材料和方法：检索了2020年1月1日至2021年7月1日期间在一家私人诊所进行了一次或多次拔牙并随后植入种植体的患者记录，并提取了数据。在植入种植体时，临床医生通过临床和影像学检查确定愈合是否成功。从患者档案中提取解释性人口统计学和临床变量，在数据缺失的情况下通过联系患者进行核对和补充。(4) 结果：纳入了69例患者，共进行了99次拔牙。暴露队列包括55个创口，而非暴露队列包括44个创口。总共有56个创口愈合成功，53个创口愈合失败。回归模型确定TC是愈合失败的显著预测因素（P = 0.014），优势比为2.86。使用特罗皮质醇治疗的创口在距牙槽嵴-1毫米、-3毫米和-5毫米水平处的骨缺损明显更大，最大垂直和水平骨缺损也明显更大。在使用特罗皮质醇的创口处，报告的手术并发症明显更多（70.91% 对18.18%，P < 0.001）。(5) 结论：用特罗皮质醇治疗的新鲜拔牙创口愈合失败的可能性增加，优势比为2.86。在先前用TC治疗的部位计划植入种植体时，更大的缺损尺寸导致明显更多的限制。
