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反应性软组织用于牙槽嵴保存的疗效:一项前瞻性队列研究。

Efficacy of reactive soft tissue for alveolar ridge preservation: a prospective cohort study.

作者信息

Jiang Shuang, Sheng Rui, Yuan Quan, Yang Xingmei

机构信息

State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases&Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China.

出版信息

Clin Oral Investig. 2024 Dec 5;28(12):684. doi: 10.1007/s00784-024-06073-8.

Abstract

OBJECTIVES

This study aimed to investigate the effect of alveolar ridge preservation (ARP) sealing using reactive soft tissue (RST) or collagen sponge (CS), in combination with deproteinized bovine bone mineral (DBBM), for teeth with bone deficiency.

MATERIALS AND METHODS

In this study, 44 patients were recruited. During ARP therapy, RST or CS was applied for socket sealing. Horizontal and vertical bone dimensions were assessed before extraction (T0) and 6 months after ARP (T2). Modified Masse healing index (HI) was recorded to evaluate the soft tissue healing at 14 days after ARP (T1) and T2. Keratinized mucosa width (KMW) was measured at T0 and T2. Biopsies were collected during implant placement for histological analysis.

RESULTS

This study was finished by 40 patients. Horizontal ridge gains at 1, 3, and 5 mm below the crest were comparable in RST (4.37/5.57/4.16 mm) and CS (3.57/4.66/2.97 mm) groups. Similar vertical bone gains at both buccal and lingual sides were observed in RST and CS groups. Notably, the sockets in the RST group exhibited a significantly better early healing score (6) at T1 relative to the CS group (7) (p = 0.003). There was no significant difference in KMW changes as well as new bone proportion between the groups.

CONCLUSIONS

RST and CS, when combined with DBBM, both effectively reduced ridge resorption in sockets with bone deficiency. RST demonstrated a more favorable effect on the early healing of sockets.

CLINICAL RELEVANCE

RST is a promising socket sealing material in ARP, which reduces bone resorption, and promotes soft tissue healing.

TRIAL REGISTRATION

Clinical trial registration Number: ChiCTR2200061459.

摘要

目的

本研究旨在探讨使用反应性软组织(RST)或胶原海绵(CS)联合脱蛋白牛骨矿物质(DBBM)对骨量不足的牙齿进行牙槽嵴保存(ARP)封闭的效果。

材料与方法

本研究招募了44例患者。在ARP治疗期间,应用RST或CS进行拔牙窝封闭。在拔牙前(T0)和ARP治疗后6个月(T2)评估水平和垂直骨尺寸。记录改良的Masse愈合指数(HI)以评估ARP治疗后14天(T1)和T2时的软组织愈合情况。在T0和T2测量角化黏膜宽度(KMW)。在种植体植入期间采集活检组织进行组织学分析。

结果

本研究由40例患者完成。RST组(4.37/5.57/4.16 mm)和CS组(3.57/4.66/2.97 mm)在牙槽嵴顶以下1、3和5 mm处的水平牙槽嵴增量相当。RST组和CS组在颊侧和舌侧均观察到相似的垂直骨增量。值得注意的是,与CS组(7分)相比,RST组在T1时拔牙窝的早期愈合评分显著更高(6分)(p = 0.003)。两组之间KMW变化以及新骨比例无显著差异。

结论

RST和CS与DBBM联合使用时,均能有效减少骨量不足拔牙窝的牙槽嵴吸收。RST对拔牙窝的早期愈合显示出更有利的效果。

临床意义

RST是ARP中有前景的拔牙窝封闭材料,可减少骨吸收并促进软组织愈合。

试验注册

临床试验注册号:ChiCTR2200061459。

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