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同种异体骨移植联合或不联合可注射富血小板纤维蛋白进行拔牙后牙槽嵴保存的组织学、临床和影像学结果比较:一项双盲随机对照临床试验

Comparison of Histological, Clinical, and Radiographic Outcomes of Postextraction Ridge Preservation by Allogenic Bone Grafting With and Without Injectable Platelet-Rich Fibrin: A Double-Blinded Randomized Controlled Clinical Trial.

作者信息

Talebi Ardakani Mohammad Reza, Rezaei Esfahrood Zeinab, Mashhadiabbas Fatemeh, Hatami Masoud

机构信息

Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Oral and Maxillofacial Pathology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Int J Dent. 2024 Oct 24;2024:8850664. doi: 10.1155/2024/8850664. eCollection 2024.

Abstract

This randomized controlled clinical trial compared the histological, clinical, and radiographic outcomes of postextraction ridge preservation by allogenic bone grafting with and without injectable platelet-rich fibrin (I-PRF). Twenty single-rooted maxillary and mandibular teeth to be extracted and replaced by dental implants were randomly divided into two groups ( = 10). Cone-beam computed tomography (CBCT) scans were obtained preoperatively to assess bone dimensions and ridge width. The teeth were then extracted, and tooth socket preservation was performed with allograft and collagen type 1 in the control group and allograft, collagen type 1, and I-PRF in the intervention group. CBCT scans were obtained again 3 months after the first stage of surgery, and the second stage of surgery was performed for implant placement, ridge width measurement, and obtaining a biopsy sample. Radiographic bone width, clinical bone width, and radiographic bone height were measured. A histomorphometric method was applied to quantify residual graft material, new bone formation, and nonmineralized tissues. The data were analyzed with Student's -test and Mann-Whitney test ( = 0.05). The intervention group showed a significantly smaller reduction in radiographic bone width (=0.038) and clinical bone width (=0.033), reduction in radiographic bone height (=0.213) was not significant. A significantly lower percentage of residual graft particles (=0.021) and a significantly higher mean percentage of newly formed bone (=0.038) than the control group. However, the difference in the percentage of nonmineralized tissue (=0.208) was not significant. Despite the optimal outcome of ridge preservation in both groups, the application of allograft plus I-PRF yielded superior histological, clinical, and radiographic results compared with allograft alone, and this difference was significant in most variables.

摘要

这项随机对照临床试验比较了使用和不使用可注射富血小板纤维蛋白(I-PRF)的同种异体骨移植进行拔牙后牙槽嵴保存的组织学、临床和影像学结果。将20颗待拔除并由牙种植体替代的单根上颌和下颌牙齿随机分为两组(每组n = 10)。术前进行锥形束计算机断层扫描(CBCT)以评估骨尺寸和牙槽嵴宽度。然后拔除牙齿,对照组使用同种异体骨和I型胶原蛋白进行牙槽窝保存,干预组使用同种异体骨、I型胶原蛋白和I-PRF进行牙槽窝保存。在手术第一阶段3个月后再次进行CBCT扫描,并进行第二阶段手术以植入种植体、测量牙槽嵴宽度并获取活检样本。测量影像学骨宽度、临床骨宽度和影像学骨高度。采用组织形态计量学方法量化残留移植材料、新骨形成和非矿化组织。数据采用学生t检验和曼-惠特尼U检验进行分析(α = 0.05)。干预组的影像学骨宽度减少量(P = 0.038)和临床骨宽度减少量(P = 0.033)明显较小,影像学骨高度减少量(P = 0.213)不显著。与对照组相比,残留移植颗粒的百分比明显更低(P = 0.021),新形成骨的平均百分比明显更高(P = 0.038)。然而,非矿化组织百分比的差异(P = 0.208)不显著。尽管两组牙槽嵴保存的结果均最佳,但与单独使用同种异体骨相比,同种异体骨加I-PRF的应用在组织学、临床和影像学方面产生了更好的结果,并且在大多数变量中这种差异具有显著性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d10a/11527539/d971f21f8387/IJD2024-8850664.001.jpg

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