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两种不同合成骨移植材料在拔牙后牙槽嵴保存中的效率:一项分侧研究。

The efficiency of two different synthetic bone graft materials on alveolar ridge preservation after tooth extraction: a split-mouth study.

机构信息

Maxillofacial Surgery Department, College of Dentistry, Arab University for Science & Technology, Hama, Syrian Arab Republic.

Maxillofacial Surgery Department, College of Dentistry, Wadi International University, Homs, Syrian Arab Republic.

出版信息

BMC Oral Health. 2024 Sep 4;24(1):1040. doi: 10.1186/s12903-024-04803-8.

Abstract

BACKGROUND

Alveolar Bone loss occurs frequently during the first six months after tooth extraction. Various studies have proposed different methods to reduce as much as possible the atrophy of the alveolar ridge after tooth extraction. Filling the socket with biomaterials after extraction can reduce the resorption of the alveolar ridge. We compared the height of the alveolar process at the mesial and distal aspects of the extraction site and the resorption rate was calculated after the application of HA/β-TCP or synthetic co-polymer polyglycolic - polylactic acid PLGA mixed with blood to prevent socket resorption immediately and after tooth extraction.

METHODS

The study was conducted on 24 extraction sockets of impacted mandibular third molars bilaterally, vertically, and completely covered, with a thin bony layer. HA/β-TCP was inserted into 12 of the dental sockets immediately after extraction, and the synthetic polymer PLGA was inserted into 12 of the dental sockets. All sockets were covered completely with a full-thickness envelope flap. Follow-up was performed for one year after extraction, using radiographs and stents for the vertical alveolar ridge measurements.

RESULTS

The mean resorption rate in the HA/β-TCP and PLGA groups was ± 1.23 mm and ± 0.1 mm, respectively. A minimal alveolar bone height reduction of HA/β-TCP was observed after 9 months, the reduction showed a slight decrease to 0.93 mm, while this rate was 0.04 mm after 9 months in the PLGA group. Moreover, the bone height was maintained after three months, indicating a good HA/β-TCP graft performance in preserving alveolar bone (1.04 mm) while this rate was (0.04 mm) for PLGA.

CONCLUSION

The PLGA graft demonstrated adequate safety and efficacy in dental socket preservation following tooth extraction. However, HA/β-TCP causes greater resorption at augmented sites than PLGA, which clinicians should consider during treatment planning.

摘要

背景

拔牙后最初的六个月,牙槽骨经常会发生流失。各种研究提出了不同的方法,旨在尽可能减少拔牙后牙槽嵴的萎缩。拔牙后在牙槽窝中填充生物材料可以减少牙槽嵴的吸收。我们比较了拔牙部位近远中颊舌侧牙槽嵴的高度,并在拔牙后立即应用 HA/β-TCP 或合成共聚物聚乙交酯-丙交酯 PLGA 与血液混合来防止牙槽窝吸收,以评估其对牙槽嵴吸收的预防效果。

方法

本研究纳入了 24 例双侧完全覆盖、牙槽骨菲薄的下颌第三磨牙埋伏阻生的拔牙窝。其中 12 个拔牙窝在拔牙后立即植入 HA/β-TCP,另外 12 个拔牙窝植入合成聚合物 PLGA。所有拔牙窝均采用全厚信封瓣完全覆盖。拔牙后随访 1 年,使用 X 线片和支抗测量牙槽嵴的垂直高度。

结果

HA/β-TCP 组和 PLGA 组的平均吸收速率分别为±1.23mm 和±0.1mm。HA/β-TCP 组在 9 个月时观察到最小牙槽骨高度减少,减少量略降至 0.93mm,而 PLGA 组在 9 个月时则为 0.04mm。此外,PLGA 组在 3 个月后骨高度保持稳定,表明 HA/β-TCP 移植物在保持牙槽骨方面具有良好的性能(1.04mm),而 PLGA 组为(0.04mm)。

结论

PLGA 移植物在拔牙后牙槽窝保存中表现出足够的安全性和有效性。然而,HA/β-TCP 导致增强部位的吸收大于 PLGA,临床医生在治疗计划中应予以考虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0a2/11375842/89f4b744f58b/12903_2024_4803_Fig1_HTML.jpg

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