Shin Hae Jee, Park Jin-Young, Tien Hsu Kuo, Strauss Franz-Josef, Cha Jae-Kook, Lee Jung-Seok
Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea.
Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland.
J Periodontol. 2025 Mar;96(3):279-289. doi: 10.1002/JPER.24-0125. Epub 2024 Jul 15.
To compare bone regeneration and dimensional alteration of alveolar ridge at intact and damaged extraction sockets after alveolar ridge preservation (ARP) and implant placement versus unassisted socket healing followed by guided bone regeneration (GBR) with simultaneous implant placement.
In 6 beagle dogs, 3 types of extraction sockets in the mandible were created: (1) intact sockets, (2) 1-wall defect sockets and (3) 2-wall defect sockets. The sockets were allocated to undergo either (1) ARP and implant placement 8 weeks later (ARP group) or (2) GBR with simultaneous implant placement after 8 weeks of unassisted socket healing (GBR group). After an additional healing period of 8 weeks, bone regeneration and dimensional changes were evaluated radiographically and histologically.
GBR showed superior bone formation and greater bone gains compared to ARP, regardless of the initial extraction-socket configuration. Although ARP maintained the preexisting alveolar ridge dimensions, peri-implant bone defects were still detected at 8 weeks of follow-up. Histomorphometric analyses confirmed that GBR increased dimensions of the alveolar ridge compared to baseline, and the augmentation and bone regeneration were greater with GBR than with ARP.
Early implant placement with ARP can mitigate alveolar ridge changes in the narrow alveolar ridge. However, early implant placement with simultaneous GBR creates the conditions for enhanced bone regeneration around the implant and greater ridge augmentation compared to ARP, irrespective of the extraction-socket configuration.
比较牙槽嵴保存（ARP）和种植体植入后完整及受损拔牙窝的骨再生情况和牙槽嵴尺寸变化，与无辅助拔牙窝愈合后同期进行引导骨再生（GBR）并植入种植体的情况。
在6只比格犬的下颌骨上制备3种类型的拔牙窝：（1）完整拔牙窝，（2）单壁骨缺损拔牙窝和（3）双壁骨缺损拔牙窝。将拔牙窝分配为接受以下两种处理之一：（1）ARP并在8周后植入种植体（ARP组）或（2）在无辅助拔牙窝愈合8周后同期进行GBR并植入种植体（GBR组）。在额外8周的愈合期后，通过影像学和组织学评估骨再生和尺寸变化。
无论初始拔牙窝形态如何，与ARP相比，GBR均显示出更好的骨形成和更大的骨增量。尽管ARP维持了原有的牙槽嵴尺寸，但在随访8周时仍检测到种植体周围骨缺损。组织形态计量学分析证实，与基线相比，GBR增加了牙槽嵴的尺寸，且GBR的增量和骨再生比ARP更大。
早期进行ARP并植入种植体可减轻窄牙槽嵴的牙槽嵴变化。然而，与ARP相比，早期同期进行GBR并植入种植体可为种植体周围增强骨再生和更大的牙槽嵴增量创造条件，而与拔牙窝形态无关。
