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富含透明质酸同种异体移植物增强牙槽嵴保存:含透明质酸和不含透明质酸的同种异体移植物颗粒的比较研究。

Enhanced alveolar ridge preservation with hyaluronic acid-enriched allografts: a comparative study of granular allografts with and without hyaluronic acid addition.

机构信息

Private Clinic for Oral, Maxillofacial and Plastic Facial Surgery, Kärntnerstraße 62, Lienz, 9900, Austria.

Department of Radiology, Landeskrankenhaus Villach, Nikolaigasse 43, Villach, 9500, Austria.

出版信息

Int J Implant Dent. 2024 Oct 9;10(1):42. doi: 10.1186/s40729-024-00559-6.

Abstract

PURPOSE

Ridge preservation is essential to restore alveolar ridge volume and to enhance esthetic and functional outcomes for dental implants. The addition of hyaluronic acid to allogeneic bone substitute materials might enhance these outcomes. This clinical study evaluated the efficacy of ridge preservation after tooth extraction using granular allografts with and without hyaluronic acid addition.

METHODS

In this retrospective study, 40 patients with compromised extraction sockets were enrolled. Among them, 19 received particulate allogeneic bone substitutes (Allo), 21 received allogeneic bone substitutes with hyaluronic acid (AlloHya). Vertical and horizontal graft stability, graft shrinkage rate, and bone mineral density were assessed using radiographic measurements on CBCT scans conducted before tooth extraction, directly after ridge preservation and after four months. Patients were followed up 12 months post-implantation.

RESULTS

Vertical height loss after 4 months was significantly greater in the Allo group (-0.82 ± 0.95 mm) compared to the AlloHya group (-0.19 ± 0.51 mm; p = 0.011). Graft shrinkage rate was 16.9 ± 11.5% (Allo) and 10.3 ± 7.7% (AlloHya) (p = 0.038). After four months, average bone density was significantly higher in the AlloHya compared to the Allo group (p = 0.004). Nearly all implants (39 out of 40) were classified as "Success" according to the ICOI scheme, with no differences in implant quality between the two study groups.

CONCLUSIONS

Improved graft stability, reduced resorption, and increased bone density were observed in hyaluronic acid-enriched allografts compared to pure allografts. Adding hyaluronic acid to allogeneic bone grafts significantly enhanced outcomes in ridge preservation.

摘要

目的

牙槽嵴保存对于恢复牙槽嵴体积以及提高牙种植体的美观和功能效果至关重要。在同种异体骨替代材料中添加透明质酸可能会增强这些效果。本临床研究评估了使用添加和不添加透明质酸的颗粒状同种异体移植物进行拔牙后牙槽嵴保存的效果。

方法

在这项回顾性研究中,纳入了 40 名牙槽骨缺损的患者。其中 19 名患者接受了颗粒状同种异体骨替代物(Allo),21 名患者接受了添加透明质酸的同种异体骨替代物(AlloHya)。使用锥形束计算机断层扫描(CBCT)扫描在拔牙前、牙槽嵴保存后直接和 4 个月后进行放射影像学测量,评估垂直和水平移植物稳定性、移植物收缩率和骨矿物质密度。患者在植入后 12 个月进行随访。

结果

4 个月后,Allo 组的垂直高度损失明显大于 AlloHya 组(-0.82±0.95mm 比 -0.19±0.51mm;p=0.011)。移植物收缩率为 16.9±11.5%(Allo)和 10.3±7.7%(AlloHya)(p=0.038)。4 个月后,AlloHya 组的平均骨密度明显高于 Allo 组(p=0.004)。根据 ICOI 方案,几乎所有植入物(40 个中的 39 个)均被归类为“成功”,两组研究之间的植入物质量无差异。

结论

与纯同种异体移植物相比,富含透明质酸的同种异体移植物具有更好的移植物稳定性、减少吸收和增加骨密度。在同种异体骨移植中添加透明质酸可显著提高牙槽嵴保存的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/719e/11465134/db0f1c037a0b/40729_2024_559_Fig1_HTML.jpg

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