Iida Takahisa, Botticelli Daniele, Miki Michihide, Muñoz Guzon Fernando M, Ferri Mauro, De Rossi Ermenegildo Federico, Baba Shunsuke
Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, 573-1121, Osaka, Japan.
ARDEC Academy, Viale Giovanni Pascoli 67, Rimini, 47923, Italy.
Oral Maxillofac Surg. 2024 Dec 28;29(1):21. doi: 10.1007/s10006-024-01315-1.
The pre-extraction overbuilding procedure was designed aiming to mitigate buccal bone resorption following tooth extraction. The objective of this study was to compare the efficacy of pre-extraction and juxta-extraction buccal overbuilding treatments in preserving buccal bone volume following tooth extraction.
At the test sites (pre-extraction sites), an alveolar crest overbuilding was performed on the buccal aspect of the distal root of the fourth premolar using a xenograft covered with a collagen membrane. No treatment was applied at the control sites. After 3 months, the distal roots of both fourth premolars were extracted and the alveoli were filled with a collagenated xenograft. An overbuilt procedure was performed also at the control sites (juxta-extraction sites). After 3 months, biopsies were collected.
Considering the initial height difference between the lingual and buccal bone plates at the time of extraction, histological evaluation revealed that the resorption of the buccal bone relative to the lingual bone wall was 3.2 mm at the pre-extraction sites and 3.3 mm at the juxta-extraction sites. New bone originated from the residual pre-existing bone crest in an attempt to restore the original dimension.
The buccal overbuilding procedures performed three months before tooth extraction did not contribute to preserve the buccal bone crest, despite necessitating an additional surgical procedure. Evidence of ongoing bone regeneration was observed within the augmented space maintained by the biomaterial, suggesting that a prolonged healing period, potentially exceeding six months as indicated by this study, might be required to achieve optimal outcomes.
拔牙前过度植骨程序旨在减轻拔牙后颊侧骨吸收。本研究的目的是比较拔牙前和拔牙时颊侧过度植骨治疗在拔牙后保留颊侧骨量方面的疗效。
在试验部位（拔牙前部位），使用覆盖胶原膜的异种移植物在第四前磨牙远中根的颊侧进行牙槽嵴过度植骨。对照部位不进行治疗。3个月后，拔除两颗第四前磨牙的远中根，牙槽窝用胶原化异种移植物填充。对照部位（拔牙时部位）也进行过度植骨程序。3个月后，采集活检样本。
考虑到拔牙时舌侧和颊侧骨板之间的初始高度差异，组织学评估显示，拔牙前部位颊侧骨相对于舌侧骨壁的吸收为3.2毫米，拔牙时部位为3.3毫米。新骨源自残留的原有骨嵴，试图恢复原始尺寸。
尽管需要额外的手术操作，但在拔牙前三个月进行的颊侧过度植骨程序对保留颊侧骨嵴并无帮助。在生物材料维持的增大空间内观察到持续骨再生的证据，这表明可能需要延长愈合期（本研究表明可能超过六个月）才能达到最佳效果。
