Foster Joelle E, Coleman Claire C, Palaiologou Archontia A, Mealey Brian L
Department of Periodontics, UT (University of Texas) Health San Antonio School of Dentistry, San Antonio, Texas, USA.
J Periodontol. 2025 Jul 24. doi: 10.1002/jper.11374.
Allografts and xenografts are viable options for alveolar ridge preservation. This study evaluated histologic wound healing when using demineralized freeze-dried bone allograft (DFDBA) alone, in fiber or particulate form, and in combination with xenograft. Alveolar dimensional changes were also evaluated.
This four-arm, parallel, randomized controlled trial included 120 patients with a nonmolar tooth receiving extraction and ridge preservation who were blindly randomized into one of four groups: DFDBA particulate alone (DCP), DFDBA fibers alone (DCF), xenograft combined with DCP (DPX), and xenograft combined with DCF (DFX). After 18-20 weeks of healing, bone cores were collected for histologic analysis of vital bone, residual allograft, residual xenograft, and connective tissue. Ridge dimensional changes were evaluated with standardized measuring stents.
There was no difference in mean vital bone formation between DCP (37.33%) and DCF (40.76%) or between DPX (24.46%) or DFX (23.85%), but more vital bone was present when DFDBA in either form was used alone (DCF, DCP) compared to combining with xenograft (DFX, DPX). Significantly less residual allograft was found in DCF (3.57%) compared to DCP (16.5%). Similarly, when combined with xenograft, there was less residual allograft with DFDBA fibers (DFX = 2.19%) than with particles (DPX = 9.88%). No significant differences in alveolar ridge dimensional change were noted between the groups.
DFDBA fibers resulted in less residual allograft compared to DFDBA particulate. Allograft-alone groups had more vital bone than groups with xenograft, but there was no difference between fiber allograft and particulate allograft alone.
Clinicaltrials.gov NCT05400213 PLAIN LANGUAGE SUMMARY: Placing a bone graft in the socket after tooth extraction can decrease bone loss during healing in preparation for a dental implant. This study collected histologic wound healing data on human bone graft materials in a fiber and particle form alone and in combination with a cow-derived (bovine) bone graft material. One hundred twenty patients who needed a tooth extracted enrolled in the study, and one of the four bone graft materials was placed in the site. After 18-20 weeks of healing, patients returned for placement of a dental implant. At this time, a bone sample was collected for microscopic examination. Measurements of the bone dimensions at the site were also done. The fiber bone graft material resorbed more rapidly relative to the particulate form, but there was no difference in new bone formed between the fibers and particles. The human bone grafts in either fiber or particle form used alone also formed more new bone than when they were mixed with the bovine bone graft. Clinically, the bone dimensions did not show significant differences between the four groups.
同种异体移植物和异种移植物是牙槽嵴保存的可行选择。本研究评估了单独使用脱矿冻干同种异体骨（DFDBA），以纤维或颗粒形式，以及与异种移植物联合使用时的组织学伤口愈合情况。还评估了牙槽嵴尺寸变化。
这项四臂、平行、随机对照试验纳入了120例接受拔牙和牙槽嵴保存的非磨牙患者，他们被随机分为四组之一：单独使用DFDBA颗粒（DCP）、单独使用DFDBA纤维（DCF）、异种移植物与DCP联合（DPX）、异种移植物与DCF联合（DFX）。愈合18 - 20周后，收集骨芯用于对活性骨、残留同种异体移植物、残留异种移植物和结缔组织进行组织学分析。使用标准化测量支架评估牙槽嵴尺寸变化。
DCP组（37.33%）和DCF组（40.76%）之间，以及DPX组（24.46%）和DFX组（23.85%）之间的平均活性骨形成无差异，但与异种移植物联合使用（DFX、DPX）相比，单独使用任何一种形式的DFDBA（DCF、DCP）时活性骨更多。与DCP组（16.5%）相比，DCF组（3.57%）的残留同种异体移植物明显更少。同样，与异种移植物联合使用时，DFDBA纤维（DFX = 2.19%）的残留同种异体移植物比颗粒（DPX = 9.88%）更少。各组之间牙槽嵴尺寸变化无显著差异。
与DFDBA颗粒相比，DFDBA纤维导致的残留同种异体移植物更少。单独使用同种异体移植物的组比使用异种移植物的组有更多活性骨，但单独的纤维同种异体移植物和颗粒同种异体移植物之间无差异。
Clinicaltrials.gov NCT05400213 通俗易懂的总结：拔牙后在牙槽窝内植入骨移植材料可减少愈合过程中的骨丢失，为牙种植做准备。本研究收集了单独以纤维和颗粒形式以及与牛源（牛）骨移植材料联合使用的人骨移植材料的组织学伤口愈合数据。120例需要拔牙的患者参与了研究，并在拔牙部位植入四种骨移植材料之一。愈合18 - 20周后，患者返回进行牙种植体植入。此时，采集骨样本进行显微镜检查。还对该部位的骨尺寸进行了测量。相对于颗粒形式，纤维骨移植材料吸收更快，但纤维和颗粒在新形成骨方面无差异。单独使用的纤维或颗粒形式的人骨移植材料也比与牛骨移植材料混合时形成更多新骨。临床上，四组之间的骨尺寸无显著差异。
