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上颌与下颌牙槽窝保存中牙本质来源牙齿移植的组织学对比分析:一项178例病例的回顾性研究

Comparative Histological Analysis of Dentine-Derived Tooth Grafts in Maxillary vs Mandibular Socket Preservation: A Retrospective Study of 178 Cases.

作者信息

Minetti Elio, Gianfreda Francesco, Bollero Patrizio, Annicchiarico Ciro, Daniele Monica, Padula Rossella, Mastrangelo Filiberto

机构信息

Department of Biomedical, Surgical, Dental Science, University of Milan, 20161 Milan, Italy.

Department of System Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy.

出版信息

Dent J (Basel). 2024 Oct 7;12(10):320. doi: 10.3390/dj12100320.

Abstract

(1) Background: In recent years, there has been a growing interest in tooth-derived materials as valuable alternatives to synthetic biomaterials for preventing alveolar ridge dimensional changes. This study aimed to evaluate the histological and clinical differences between alveolar ridge preservation procedures in the maxilla and mandible using demineralized dentin treated with Tooth Transformer. (2) Methods: A total of 178 patients in good general health were enrolled, with 187 post-extractive sockets lacking buccal and/or palatal bone walls. Alveolar socket preservation procedures and histological evaluations were performed. The sites were divided into two groups: Group A (99 mandibular samples) and Group B (108 maxillary samples). After 5 months (±1 month), single bone biopsies were performed for histologic and histomorphometric analysis. (3) Results: Clinical outcomes demonstrated a good healing of hard and soft tissues with an effective maintenance of bone architecture in both groups. Histomorphometric analysis revealed a total bone volume of 50.33% (±14.86) in Group A compared to 43.53% (±12.73) in Group B. The vital new bone volume was 40.59% (±19.90) in Group A versus 29.70% (±17.68) in Group B, with residual graft dentin material volume at 7.95% (±9.85) in Group A compared to 6.75% (±9.62) in Group B. (4) Conclusions: These results indicate that tooth-derived material supports hard tissue reconstruction by following the structure of the surrounding bone tissue. A 6.8% difference observed between the maxilla and mandible reflects the inherent disparities in natural bone structures in these regions. This suggests that the bone regeneration process after tooth extraction adheres to an anatomical functional pattern that reflects the specific bone characteristics of each area, thus contributing to the preservation of the morphology and functionality of the surrounding bone tissue.

摘要

(1) 背景:近年来,牙齿衍生材料作为合成生物材料的有价值替代品,在预防牙槽嵴尺寸变化方面受到越来越多的关注。本研究旨在评估使用经牙齿转化器处理的脱矿牙本质对上颌和下颌牙槽嵴保存程序的组织学和临床差异。(2) 方法:共纳入178例全身健康状况良好的患者,有187个拔牙后牙槽窝缺乏颊侧和/或腭侧骨壁。进行了牙槽窝保存程序和组织学评估。这些部位分为两组:A组(99个下颌样本)和B组(108个上颌样本)。5个月(±1个月)后,进行单次骨活检以进行组织学和组织形态计量分析。(3) 结果:临床结果显示两组硬组织和软组织愈合良好,骨结构有效维持。组织形态计量分析显示,A组的总骨体积为50.33%(±14.86),而B组为43.53%(±12.73)。A组的新生有活力骨体积为40.59%(±19.90),B组为29.70%(±17.68),A组的剩余移植牙本质材料体积为7.95%(±9.85),B组为6.75%(±9.62)。(4) 结论:这些结果表明,牙齿衍生材料通过遵循周围骨组织的结构来支持硬组织重建。上颌和下颌之间观察到的6.8%差异反映了这些区域天然骨结构的固有差异。这表明拔牙后的骨再生过程遵循一种解剖功能模式,该模式反映了每个区域的特定骨特征,从而有助于保存周围骨组织的形态和功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e193/11505686/6658b9bd8e11/dentistry-12-00320-g001.jpg

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