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异体脱矿牙基质在牙槽嵴保存中用于 socket seal 手术的能力:一项随机对照临床试验。

Competence of allogenic demineralized tooth matrix in socket seal surgery for alveolar ridge preservation: a randomized control clinical trial.

机构信息

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla, 90112, Thailand.

出版信息

Clin Oral Investig. 2024 Aug 14;28(9):484. doi: 10.1007/s00784-024-05879-w.

Abstract

OBJECTIVES

To assess and compare the clinical, radiological, and histological outcomes of socket seal surgery between two protocols: deproteinized demineralized tooth matrix (dpDTM) and freeze-dried bone allograft (FDBA) each covered with a free gingival graft.

MATERIALS AND METHODS

Twenty extraction sockets in the anterior or premolar region were randomly allocated to either the dpDTM or FDBA protocol (n = 10 per group). Measurements of the alveolar ridge changes were obtained using an intraoral scanner and cone-beam computed tomography at 3 months post-operation. Three-month post surgery, the dental implant was installed (n = 5 per group), bone biopsies were obtained for histomorphometrical and micro-computed tomography analyses. Implant stability quotients (ISQs) were determined and compared at 3 months post-implant.

RESULTS

Lower significant reductions in buccal alveolar ridge height and hard tissue volume were observed in dpDTM group compared to FDBA group at 3 months (0.25 ± 0.35 mm vs. 1.60 ± 0.66 mm [p = .000] and 9.64 ± 15.39% mm vs. 31.45 ± 18.11% mm [p = .010], respectively). At the same time, lower soft tissue volume reduction was detected in the dpDTM group compared to FDBA group (4.21 ± 5.25% mm vs. 5.25 ± 5.79% mm). No statistically significant difference in the percentage of mineralized tissue formation was found between dpDTM group (53.39 ± 11.16%) and FDBA group (49.90 ± 3.27%). Even though the ISQ in the dpDTM group showed a higher value than the FDBA group at 3 months post-implant, the results were without statistical significance.

CONCLUSIONS

Alveolar ridge preservation using dpDTM is an efficacious procedure for providing the conditions for the development of functional and esthetic implants.

摘要

目的

评估和比较两种方案(脱蛋白脱钙牙基质(dpDTM)和冻干骨移植物(FDBA),各覆盖游离龈移植)在牙槽窝封闭手术后的临床、放射学和组织学结果。

材料和方法

在前牙或前磨牙区随机选择 20 个拔牙窝,分别纳入 dpDTM 或 FDBA 方案(每组各 10 个)。术后 3 个月,使用口腔内扫描仪和锥形束计算机断层扫描测量牙槽嵴变化。术后 3 个月,安装牙种植体(每组各 5 个),获取骨活检进行组织形态计量学和微计算机断层扫描分析。确定并比较 3 个月后的种植体稳定性比。

结果

与 FDBA 组相比,dpDTM 组在术后 3 个月时牙槽嵴颊侧高度和硬组织体积的显著减少(0.25 ± 0.35mm 比 1.60 ± 0.66mm[P=0.000]和 9.64 ± 15.39%mm 比 31.45 ± 18.11%mm[P=0.010])。同时,dpDTM 组的软组织体积减少也低于 FDBA 组(4.21 ± 5.25%mm 比 5.25 ± 5.79%mm)。dpDTM 组(53.39 ± 11.16%)和 FDBA 组(49.90 ± 3.27%)之间形成的矿化组织百分比无统计学差异。尽管 dpDTM 组在植入后 3 个月时的种植体稳定性比(ISQ)值高于 FDBA 组,但结果无统计学意义。

结论

使用 dpDTM 进行牙槽嵴保存是一种有效的方法,可以为功能性和美观性种植体的发展提供条件。

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