Kim Hyunjae, Han Hee-Seung, Ghanaati Shahram, Zadeh Homayoun H, Kim Sungtae, Cho Young-Dan
Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Republic of Korea.
Department of Periodontology, Korea University Anam Hospital, Seoul, Republic of Korea.
Int Dent J. 2025 Apr;75(2):1155-1164. doi: 10.1016/j.identj.2024.07.015. Epub 2024 Aug 8.
This study sought to evaluate the efficacy of cancellous bovine bone mineral granules and 10% porcine collagen (deproteinized bovine bone mineral with collagen [DBBM-C]; (OCS-B Collagen® [Straumann XenoFlex], NIBEC, Korea) in a mouldable block form, with or without socket seal, using autogenous free gingival graft (FGG).
Fifty-four patients were included and randomly assigned to one of three groups: (1) spontaneous healing (control group), (2) alveolar ridge preservation (ARP) using DBBM-C (DBBM-C group), and (3) ARP employing DBBM-C sealed with FGG (DBBM-C/FGG group). Bone biopsy and implant fixture placement were performed 180 days after ARP. Cone-beam computed tomography, histological analysis, implant stability, and three-dimensional volumetric analysis were conducted.
Of the 54 patients, 4 dropped out owing to loss of follow-up and osseointegration failure. The changes in alveolar bone during follow-up were not significantly different. Between 84- and 180-day postextraction, the volume of the DBBM-C and DBBM-C/FGG groups was maintained at 3 mm below the alveolar ridge crest (0.72 ± 0.80 mm, 6.05 ± 6.69%), whereas the volume in the control group decreased (-0.37 ± 1.31 mm, -2.10% ± 8.37%) (P = .026). The DBBM-C/FGG group exhibited less horizontal ridge resorption at 1 mm below the alveolar crest (-9.19 ± 5.09 mm, -73.67% ± 32.53%) between preextraction and 84 days postextraction (P = .049). In all groups, the implant stability quotient remained above 70.
Within the limitations of this study, both ARP using DBBM-C with and without socket sealing effectively preserved the width dimension of the alveolar ridge, with no significant difference in alveolar bone resorption. However, socket sealing appeared to enhance the stability of the bone graft and bone quality.
The use of DBBM-C for ARP seems to aid in volume maintenance as compared with spontaneous healing. Gingival sealing with an FGG can help maintain the width of the alveolar ridge. This clinical trial was not registered prior to participant recruitment and randomization. This study was registered at WHO ICTRP (https://trialsearch.who.int/Trial2.aspx?TrialID=KCT0008266).
本研究旨在评估松质牛骨矿物质颗粒和10%猪胶原蛋白（含胶原蛋白的脱蛋白牛骨矿物质[DBBM-C]；（韩国NIBEC公司的OCS-B Collagen®[Straumann XenoFlex]）制成的可塑形块状物，无论有无牙槽窝封闭，联合自体游离龈瓣移植（FGG）的疗效。
纳入54例患者并随机分为三组：（1）自然愈合（对照组）；（2）使用DBBM-C进行牙槽嵴保存（ARP）（DBBM-C组）；（3）使用DBBM-C并联合FGG封闭进行ARP（DBBM-C/FGG组）。在ARP术后180天进行骨活检和种植体植入。进行锥形束计算机断层扫描、组织学分析、种植体稳定性和三维体积分析。
54例患者中，4例因失访和骨结合失败退出研究。随访期间牙槽骨的变化无显著差异。拔牙后84天至180天，DBBM-C组和DBBM-C/FGG组的骨量维持在牙槽嵴顶以下3mm处（0.72±0.80mm，6.05±6.69%），而对照组骨量减少（-0.37±1.31mm，-2.10%±8.37%）（P = 0.026）。DBBM-C/FGG组在拔牙前至拔牙后84天，牙槽嵴顶以下1mm处的水平向牙槽嵴吸收较少（-9.19±5.09mm，-73.67%±32.53%）（P = 0.049）。所有组的种植体稳定性商数均保持在70以上。
在本研究的局限性范围内，使用DBBM-C进行ARP，无论有无牙槽窝封闭，均能有效保存牙槽嵴的宽度尺寸，牙槽骨吸收无显著差异。然而，牙槽窝封闭似乎可增强骨移植的稳定性和骨质量。
与自然愈合相比，使用DBBM-C进行ARP似乎有助于维持骨量。用FGG进行牙龈封闭有助于维持牙槽嵴的宽度。本临床试验在招募参与者和随机分组之前未进行注册。本研究已在世界卫生组织国际临床试验注册平台（https://trialsearch.who.int/Trial2.aspx?TrialID=KCT0008266）注册。
