Hong Inpyo, Joo Jeung-Min, Kwon Yoon-Hee, Wu David T, Sanz Mariano, Jung Ui-Won, Cha Jae-Kook
Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea.
Division of Periodontology, Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA.
J Periodontal Res. 2025 Mar;60(3):255-264. doi: 10.1111/jre.13342. Epub 2024 Aug 26.
The aim of this experimental in vivo pilot study was to evaluate the effect of the local delivery of pamidronate within a collagen membrane on the changes in the buccal soft and hard tissue dimensions at the time of immediate implant placement and whether this effect was influenced by the placement of bone substitutes.
In six beagle dogs, the distal roots of the third and fourth premolars were extracted, and immediate implants were placed. Treatment groups were randomly allocated to each socket: (i) covering the buccal bone with pamidronate-soaked collagen membrane (BP group), (ii) filling the gap defect with synthetic bone substitute (BS group), (iii) filling the gap defect with synthetic bone substitute and covering the buccal bone with pamidronate soaked collagen membrane (BP/BS group), (iv) no treatment (control group). Intraoral scanning was performed immediately after the surgery and at 20 weeks. Histomorphometric and micro-computed tomography (CT) outcomes were evaluated at 20 weeks.
The micro CT analysis demonstrated that the BP group showed no apparent difference in vertical bone level with residual mesial root area, while control group showed significant buccal bone resorption at the implant site. The histomorphometric analysis demonstrated that the vertical bone level of buccal plate was significantly differed between the BP and control group (0.34 ± 0.93 and 1.27 ± 0.56 mm, respectively; p = .041). There was no statistically significant difference in the horizontal ridge width (HRW 1, 2, 3) among the groups. Also, the thickness, height and buccal contours of the soft tissue did not reveal significant changes among the groups.
The local delivery of pamidronate to the outer surface of the buccal wall at the time of immediate implant placement effectively limits buccal bone resorption. The results from the present investigation should be interpreted with caution, as well as its clinical translatability. Further investigation is needed to understand the pamidronate binding and releasing kinetic, as well as the ideal carrier of this drug for its topical application.
本体内实验性初步研究旨在评估在即刻种植时，胶原蛋白膜局部递送帕米膦酸盐对颊侧软硬组织尺寸变化的影响，以及这种影响是否受骨替代物植入的影响。
在6只比格犬中，拔除第三和第四前磨牙的远中根，并即刻植入种植体。将治疗组随机分配到每个牙槽窝：（i）用帕米膦酸盐浸泡的胶原蛋白膜覆盖颊侧骨（BP组），（ii）用合成骨替代物填充间隙缺损（BS组），（iii）用合成骨替代物填充间隙缺损并用帕米膦酸盐浸泡的胶原蛋白膜覆盖颊侧骨（BP/BS组），（iv）不进行治疗（对照组）。术后即刻和20周时进行口腔内扫描。在20周时评估组织形态计量学和微型计算机断层扫描（CT）结果。
微型CT分析表明，BP组与残留近中根区域的垂直骨水平无明显差异，而对照组在种植体部位出现明显的颊侧骨吸收。组织形态计量学分析表明，BP组和对照组之间颊侧板的垂直骨水平有显著差异（分别为0.34±0.93和1.27±0.56mm；p = 0.041）。各组之间水平牙槽嵴宽度（HRW 1、2、3）无统计学显著差异。此外，软组织的厚度、高度和颊侧轮廓在各组之间未显示出显著变化。
即刻种植时在颊壁外表面局部递送帕米膦酸盐可有效限制颊侧骨吸收。本研究结果及其临床可转化性应谨慎解释。需要进一步研究以了解帕米膦酸盐的结合和释放动力学，以及该药物局部应用的理想载体。
