Minetti Elio, Palermo Andrea, Berardini Marco
Department of Biomedical, Surgical, Dental Science, University of Milan, Milan, Italy.
College of Medicine and Dentistry, University of Birmingham, Birmingham, United Kingdom.
Eur J Dent. 2024 May;18(2):477-484. doi: 10.1055/s-0043-1772251. Epub 2023 Sep 20.
Post-extractive socket grafting techniques reduce alveolar ridge dimensional changes. Numerous graft materials have been suggested and a growing interest in tooth material has been observed as a valuable alternative to synthetic biomaterials or xenografts. Furthermore, different clinical procedures have been proposed for the wound closure of the post-extractive site. This study aims to compare histological and clinical outcomes of two different surgical techniques to seal the post-extractive site with the use of autologous demineralized extracted tooth as graft material.
Sixteen post-extractive socket without buccal and/or palatal bone walls, in sixteen healthy patients, were grafted with the autologous tooth material treated by the new Tooth Transformer device (Tooth Transformer, Milan, Italy). Alveolar socket preservation procedures were performed without flap elevation. Patients were randomly subdivided into two equal groups according to the site closure technique. In group A, the pedunculate tissue was used, while in group B ice cone technique. A bone samples were collected in each site after 4 months for histological analysis.
No significant clinical differences among the different sealing techniques were observed. In both groups, the site was filled by new bone formation after 4 months of healing. The histological analysis revealed 46.1 ± 8.07% of bone volume, 9.2 ± 9.46% of residual graft, and 35.2 ± 12.36% of vital bone in group A, while group B shows 41.22 ± 5.88% of bone volume, 7.94 ± 7.54% of residual graft, and 31.7 ± 7.52% new bone. No statistical differences were detected ( > 0.05).
Further studies with a large number of patients, and different observation periods will be needed to confirm the results of this pilot study; however, the interesting data obtained have shown how these techniques, mixed with the autologous dentin derived graft material, seem to promote bone regeneration and reduce physiological bone resorption during alveolar socket preservation treatments.
拔牙后牙槽窝植骨技术可减少牙槽嵴尺寸变化。已有多种植骨材料被提出,并且人们对牙齿材料作为合成生物材料或异种移植物的一种有价值的替代物的兴趣与日俱增。此外,针对拔牙后创口的闭合也提出了不同的临床操作方法。本研究旨在比较两种不同手术技术使用自体脱矿拔牙作为植骨材料封闭拔牙后创口的组织学和临床结果。
对16名健康患者的16个无颊侧和/或腭侧骨壁的拔牙后牙槽窝,使用新型牙齿转化器装置(牙齿转化器,意大利米兰)处理的自体牙齿材料进行植骨。在不掀起瓣的情况下进行牙槽窝保存操作。根据创口闭合技术将患者随机分为两组,每组人数相等。A组使用带蒂组织,而B组使用冰锥技术。4个月后在每个部位采集骨样本进行组织学分析。
不同封闭技术之间未观察到显著的临床差异。两组在愈合4个月后,创口均由新骨形成填充。组织学分析显示,A组骨体积为46.1±8.07%,残余移植物为9.2±9.46%,活骨为35.2±12.36%,而B组骨体积为41.22±5.88%,残余移植物为7.94±7.54%,新骨为31.7±7.52%。未检测到统计学差异(>0.05)。
需要进行更多患者参与、不同观察期的进一步研究来证实本初步研究的结果;然而,所获得的有趣数据表明,这些技术与自体牙本质衍生的植骨材料相结合,似乎在牙槽窝保存治疗期间促进骨再生并减少生理性骨吸收。