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纳米羟基磷灰石(NH)在牙槽窝保存中的应用:一项即将开展的多中心研究的交流以及一个先导病例报告的呈现。

The Use of Nano-Hydroxyapatite (NH) for Socket Preservation: Communication of an Upcoming Multicenter Study with the Presentation of a Pilot Case Report.

机构信息

Independent Researcher, 16149 Genova, Italy.

Unit of Pediatric Dentistry, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, 56126 Pisa, Italy.

出版信息

Medicina (Kaunas). 2023 Nov 9;59(11):1978. doi: 10.3390/medicina59111978.

Abstract

: The use of biomaterials in dentistry is extremely common. From a commercial perspective, different types of osteoconductive and osteoinductive biomaterials are available to clinicians. In the field of osteoconductive materials, clinicians have biomaterials made of heterologous bones at their disposal, including biomaterials of bovine, porcine, and equine origins, and biomaterials of natural origin, such as corals and hydroxyapatites. In recent years, it has become possible to synthesize nano-Ha and produce scaffolds using digital information. Although a large variety of biomaterials has been produced, there is no scientific evidence that proves their absolute indispensability in terms of the preservation of postextraction sites or in the execution of guided bone regeneration. While there is no scientific evidence showing that one material is better than another, there is evidence suggesting that several products have better in situ permanence. This article describes a preliminary study to evaluate the , and of nano-HA. : In this study, we planned to use a new biomaterial based on nanohydroxyapatite for implantation at one postextraction site; the nano-HA in this study was NuvaBONE (Overmed, Buccinasco, Milano, Italy). This is a synthetic bone graft substitute that is based on nanostructured biomimetic hydroxyapatite for application in oral-maxillofacial surgery, orthopedics, traumatology, spine surgery, and neurosurgery. In our pilot case, a patient with a hopeless tooth underwent extraction, and the large defect remaining after the removal of the tooth was filled with nano-HA to restore the volume. Twelve months later, the patient was booked for implant surgery to replace the missing tooth. At the time of the surgery, a biopsy of the regenerated tissue was taken using a trephine of 4 mm in the inner side and 8 mm deep. : The histological results of the biopsy showed abundant bone formation, high values of ISQ increasing from the insertion to the prosthetic phase, and a good reorganization of hydroxyapatite granules during resorption. The implant is in good function, and the replaced tooth shows good esthetics. : The good results of this pilot case indicate starting the next Multicentric study to have more and clearer information about this nanohydroxyapatite (NH) compared with control sites.

摘要

在牙科领域,生物材料的应用非常普遍。从商业角度来看,临床医生可获得不同类型的骨传导和骨诱导生物材料。在骨传导材料领域,临床医生可获得各种异源骨生物材料,包括牛源性、猪源性和马源性生物材料,以及珊瑚和羟磷灰石等天然来源的生物材料。近年来,通过合成纳米 HA 和使用数字信息来制作支架已经成为可能。尽管已经生产出了大量的生物材料,但没有科学证据表明它们在保存拔牙窝或执行引导骨再生方面绝对不可或缺。虽然没有科学证据表明一种材料比另一种更好,但有证据表明,一些产品具有更好的原位持久性。本文描述了一项初步研究,旨在评估纳米 HA 的 、 和 。

在这项研究中,我们计划在一个拔牙窝中植入一种基于纳米羟基磷灰石的新型生物材料;本研究中的纳米 HA 为 NuvaBONE(Overmed,Buccinasco,Milano,意大利)。这是一种基于纳米结构仿生羟基磷灰石的合成骨移植替代物,适用于口腔颌面外科、骨科、创伤学、脊柱外科和神经外科。在我们的试点案例中,一位患有无望牙齿的患者接受了拔牙,在拔牙后留下的大缺损中填充了纳米 HA 以恢复体积。12 个月后,该患者预约进行种植手术以替换缺失的牙齿。在手术时,使用内侧直径为 4 毫米、深度为 8 毫米的环钻对再生组织进行活检。

活检的组织学结果显示,大量骨形成,ISQ 值从插入到修复阶段增加,羟基磷灰石颗粒在吸收过程中得到了很好的重组。植入物功能良好,替换的牙齿美观。

这个试点案例的良好结果表明,与对照部位相比,开始下一个多中心研究可以获得更多关于这种纳米羟基磷灰石(NH)的更清晰的信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9f8/10673145/82ce323806d2/medicina-59-01978-g001.jpg

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