评估 III/IV 期牙周炎患者磨牙拔牙位点应用微瓣牙槽嵴保存和增量术的软硬组织变化：一项随机对照试验。
Assessment of soft and hard tissue changes following micro crestal flap-Alveolar ridge preservation and augmentation at molar extraction sites in patients with stage III/IV periodontitis: A randomized controlled trial.
机构信息
Department of Periodontology, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing, China.
Department of Emergency, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing, China.
出版信息
J Clin Periodontol. 2024 Oct;51(10):1311-1322. doi: 10.1111/jcpe.14045. Epub 2024 Jul 23.
AIM
This study aimed to assess hard and soft tissue contour changes following micro crestal flap-alveolar ridge preservation (MCF-ARP) and natural healing (NH) in periodontally compromised molar extraction sites and to analyse the feasibility and need for bone augmentation during implant therapy.
MATERIALS AND METHODS
Fifty-six patients with 70 sites were randomized into two groups at the site level (35 sites from 31 patients in the test group and 35 sites from 29 patients in the control group). Among whom, four patients contributed one tooth to the control group and one tooth to the test group. Hard tissue indicators were measured using cone beam computed tomography performed before tooth extraction and 6 months after surgery. Soft tissue contour changes were assessed using intraoral scanning performed before and immediately after surgery and also 2 weeks and 1, 3 and 6 months after surgery.
RESULTS
Six months after surgery, the MCF-ARP group showed less resorption in buccal bone height (p = .032) and greater augmentation in central bone height (p = .001) and ridge width (p = .009). The mean, vertical and horizontal collapse of buccal soft tissue contour in the MCF-ARP group were 0.95 mm (p = .010), 0.61 mm (p = .019) and 0.56 mm (p = .013) less than that in the NH group, respectively. There were significantly (p = .007) fewer sites in the MCF-ARP group than in the NH group (0% vs. 26.7%) for staged bone augmentation and more sites that could be treated with simple implant procedure in the MCF-ARP group than in the NH group (71.9% vs. 56.6%).
CONCLUSIONS
Compared with NH, MCF-ARP reduced bone resorption in periodontally compromised molar extraction sites and maintained the buccal soft tissue contour. MCF-ARP reduces the need for complex bone augmentation procedures in implant therapy.
TRIAL REGISTRATION
Chinese Clinical Trial Register (ChiCTR) ChiCTR2200056335. Registered on 4 February 2022, Version 1.0.
目的
本研究旨在评估牙周病患者磨牙拔牙位点采用微创黏骨膜瓣牙槽嵴保存（MCF-ARP）和自然愈合（NH）后硬组织和软组织轮廓的变化，并分析种植治疗中进行骨增量的可行性和必要性。
材料和方法
56 名患者的 70 个位点以位点为单位进行随机分组（试验组 31 名患者的 35 个位点和对照组 29 名患者的 35 个位点）。其中，4 名患者的 1 颗牙被分配到对照组，1 颗牙被分配到试验组。在拔牙前和术后 6 个月使用锥形束 CT 测量硬组织指标。在术前、术后即刻以及术后 2 周、1 个月、3 个月和 6 个月使用口内扫描仪评估软组织轮廓变化。
结果
术后 6 个月，MCF-ARP 组颊侧骨高度的吸收较少（p = .032），中央骨高度和牙槽嵴宽度的增加较多（p = .001 和 p = .009）。MCF-ARP 组颊侧软组织轮廓的平均、垂直和水平塌陷分别为 0.95 mm（p = .010）、0.61 mm（p = .019）和 0.56 mm（p = .013），均小于 NH 组。MCF-ARP 组分期骨增量的位点明显少于 NH 组（0% vs. 26.7%），而 MCF-ARP 组可通过单纯种植手术治疗的位点明显多于 NH 组（71.9% vs. 56.6%）。
结论
与 NH 相比，MCF-ARP 可减少牙周病患者磨牙拔牙位点的骨吸收，并维持颊侧软组织轮廓。MCF-ARP 减少了种植治疗中复杂骨增量手术的需求。
试验注册
中国临床试验注册中心（ChiCTR）ChiCTR2200056335。于 2022 年 2 月 4 日注册，版本 1.0。
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