Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), Bart's & The London School of Medicine & Dentistry, London, UK.
Defence Centre for Rehabilitative Dentistry, Defence Primary Health Care (DPHC), Dental Centre Aldershot, Guilford, Surry, UK.
Clin Oral Implants Res. 2024 Nov;35(11):1452-1466. doi: 10.1111/clr.14332. Epub 2024 Aug 6.
Examine the histomorphometric bone composition, following alveolar ridge preservation techniques and unassisted socket healing.
Forty-two patients (42) requiring a single rooted tooth extraction were randomly allocated into three groups (n = 14 per group): Group 1: Guided Bone Regeneration (GBR) using deproteinised bovine bone mineral (DBBM) and a porcine collagen membrane; Group 2: Socket Seal (SS) technique using DBBM and a porcine collagen matrix; Group 3: Unassisted socket healing (Control). Trephined bone biopsies were harvested following a 4-month healing period. Forty-two samples underwent Back-Scattered Electrons -Scanning Electron Microscopy (BSE-SEM) imaging, with 15 samples examined using Xray Micro-Tomography (XMT) (n = 6 for each GBR/SS and n = 3 Control). Images were analysed to determine the percentage (%) of connective tissue, new bone formation, residual DBBM particles and direct bone to DBBM particle contact (osseointegration).
BSE-SEM analysis demonstrated that new bone formation was higher in the Control (45.89% ± 11.48) compared to both GBR (22.12% ± 12.7/p < .004) and SS (27.62% ± 17.76/p < .005) groups. The connective tissue percentage in GBR (49.72% ± 9), SS (47.81% ± 12.57) and Control (47.81% ± 12.57) groups was similar. GBR (28.17% ± 16.64) and SS (24.37% ± 18.61) groups had similar levels of residual DBBM particles. XMT volumetric analysis indicated a lower level of bone and DBBM particles in all test groups, when matched to the BSE-SEM area measurements. Osseointegration levels (DBBM graft and bone) were recorded at 35.66% (± 9.8) for GBR and 31.18% (± 19.38) for SS.
GBR and SS ARP techniques presented with less bone formation when compared to unassisted healing. GBR had more direct contact/osseointegration between the DBBM particles and newly formed bone.
研究牙槽嵴保存技术和非辅助性牙槽窝愈合后，组织学的骨成分。
42 名（42 颗）需拔除单根牙的患者被随机分为三组（每组 14 名患者）：组 1：使用脱蛋白牛骨矿物质（DBBM）和猪胶原膜的引导骨再生（GBR）；组 2：使用 DBBM 和猪胶原基质的牙槽窝封闭（SS）技术；组 3：非辅助性牙槽窝愈合（对照组）。在 4 个月的愈合期后，采集了磨牙活检。42 个样本进行了背散射电子扫描电子显微镜（BSE-SEM）成像，其中 15 个样本使用 X 射线微断层扫描（XMT）（GBR/SS 各 6 个，对照组 3 个）进行了检查。分析图像以确定结缔组织、新骨形成、残留 DBBM 颗粒和直接骨与 DBBM 颗粒接触（骨整合）的百分比（%）。
BSE-SEM 分析表明，对照组（45.89%±11.48）的新骨形成高于 GBR（22.12%±12.7/p<.004）和 SS（27.62%±17.76/p<.005）组。GBR（49.72%±9）、SS（47.81%±12.57）和对照组（47.81%±12.57）的结缔组织百分比相似。GBR（28.17%±16.64）和 SS（24.37%±18.61）组的残留 DBBM 颗粒水平相似。XMT 体积分析表明，与 BSE-SEM 面积测量相比，所有测试组的骨和 DBBM 颗粒水平较低。GBR 的骨整合水平（DBBM 移植物和骨）为 35.66%（±9.8），SS 为 31.18%（±19.38）。
与非辅助性愈合相比，GBR 和 SS ARP 技术的骨形成较少。GBR 中 DBBM 颗粒与新形成的骨之间具有更多的直接接触/骨整合。
