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牙周受损磨牙拔牙窝牙槽嵴保存的效果:一项回顾性队列研究。

Effect of alveolar ridge preservation at periodontally compromised molar extraction sockets: A retrospective cohort study.

作者信息

Dai Anna, Li Hao-Yu, Kang Sen, Lin Renjie, Huang Jia-Ping, Mao Feifei, Ding Pei-Hui

机构信息

Key Laboratory of Oral Biomedical Research of Zhejiang Province, School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Cancer Center of Zhejiang University, Zhejiang University School of Medicine, Stomatology Hospital, Hangzhou, China.

School of Stomatology, Zhejiang Chinese Medical University, Hangzhou, China.

出版信息

J Periodontol. 2025 Jan;96(1):9-20. doi: 10.1002/JPER.24-0064. Epub 2024 Jun 17.

Abstract

BACKGROUND

To date, the clinical evidence regarding the effectiveness of alveolar ridge preservation (ARP) in restricting alveolar bone height and width change after extraction at periodontally compromised molar extraction sockets still remains controversial. This retrospective cohort study aims to evaluate the effect of ARP in molars extracted for periodontal reasons.

METHODS

Retrospective data were collected from patient electronic records from January 2019 to December 2023. Patients with Stage III/IV periodontitis who underwent extraction of molars for periodontal reasons were screened for eligibility. The outcomes included the horizontal and vertical dimensions of alveolar bone. The need for additional augmentation procedure during implantation was also evaluated. A linear regression model was used to adjust for known confounders.

RESULTS

A total of 80 sockets were included in this study, of which 27 sockets received ARP therapy after extraction while 53 sockets experienced natural healing (NH). ARP resulted in significantly less bone height change in the periodontally compromised molar sites compared to the NH group (p < 0.001). In sockets displaying a height disparity of >2 mm between the buccal and palatal/lingual walls, the ARP group exhibited advantageous outcomes in terms of ridge width change, surpassing the NH group (p = 0.004). Moreover, the percentage for additional augmentation was significantly reduced in the ARP compared to the NH group (p = 0.006). Age, sex, smoking, jaw, location, and buccal wall thickness did not show any significant effect on bone height change.

CONCLUSION

ARP had benefits on limiting ridge resorption subsequent to molar extraction for periodontal reasons.

摘要

背景

迄今为止,关于牙槽嵴保存术(ARP)在限制牙周状况不佳的磨牙拔牙窝拔牙后牙槽骨高度和宽度变化方面有效性的临床证据仍存在争议。这项回顾性队列研究旨在评估ARP在因牙周原因拔除磨牙中的效果。

方法

从2019年1月至2023年12月的患者电子记录中收集回顾性数据。筛选因牙周原因接受磨牙拔除术的III/IV期牙周炎患者的资格。结果包括牙槽骨的水平和垂直尺寸。还评估了植入期间是否需要额外的增量手术。使用线性回归模型调整已知的混杂因素。

结果

本研究共纳入80个拔牙窝,其中27个拔牙窝在拔牙后接受了ARP治疗,而53个拔牙窝经历了自然愈合(NH)。与NH组相比,ARP导致牙周状况不佳的磨牙部位骨高度变化明显更小(p < 0.001)。在颊侧和腭侧/舌侧壁之间高度差异>2 mm的拔牙窝中,ARP组在牙槽嵴宽度变化方面表现出优势,超过NH组(p = 0.004)。此外,与NH组相比,ARP组额外增量的百分比显著降低(p = 0.006)。年龄、性别、吸烟情况、颌骨、位置和颊侧骨壁厚度对骨高度变化均未显示出任何显著影响。

结论

ARP在限制因牙周原因拔除磨牙后的牙槽嵴吸收方面具有益处。

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