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用针固定胶原膜对即刻牙种植部位颊侧骨再生的影响:犬的临床前研究

The Effect of Collagen Membrane Fixation with Pins on Buccal Bone Regeneration in Immediate Dental Implant Sites: A Preclinical Study in Dogs.

作者信息

Hazama Yuma, Iida Takahisa, Lang Niklaus P, Muñoz Guzon Fernando M, Iezzi Giovanna, Botticelli Daniele, Baba Shunsuke

机构信息

Department of Oral Implantology, School of Dentistry, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, Osaka 573-1121, Japan.

ARDEC Academy, 47923 Rimini, Italy.

出版信息

J Funct Biomater. 2025 Jul 31;16(8):281. doi: 10.3390/jfb16080281.

Abstract

BACKGROUND

The role of collagen membrane fixation during guided bone regeneration (GBR) remains debatable, particularly in post-extraction sockets with buccal defects and concomitant immediate implant placement. This study evaluated whether or not fixation with titanium pins improved regenerative outcomes.

METHODS

Six adult Beagle dogs received bilateral extractions of the fourth mandibular premolars. An implant was immediately placed in both the distal alveoli, and standardized buccal bone defects (5 mm height, 3-2 mm width) were prepared. All defects were filled with a slowly resorbing equine xenograft and covered by a resorbable pericardium membrane. At the test sites, the membrane was apically fixed with pins, while no fixation was applied to the control sites. After 3 months of healing, histomorphometric analyses were performed.

RESULTS

The vertical bone gain of the buccal crest was 3.2 mm in the test sites (pin group) and 2.9 mm in the control sites (no-pin) ( > 0.754). No significant difference was found in terms of bone-to-implant contact (BIC). However, residual graft particles were located significantly more coronally in the pin group compared to the no-pin group ( = 0.021). Morphometric analyses revealed similar new bone formation within the groups, but with higher amounts of residual xenograft and soft tissue in the pin group.

CONCLUSIONS

Membrane fixation did not significantly enhance vertical bone gain, and although the slightly higher regeneration in the pin group (3.2 mm vs. 2.9 mm) may hold clinical relevance in esthetically sensitive areas and osseointegration, it appeared to limit apical migration of the grafting material.

摘要

背景

引导骨再生(GBR)过程中胶原膜固定的作用仍存在争议,尤其是在伴有颊侧骨缺损并同时即刻种植的拔牙创中。本研究评估了钛钉固定是否能改善再生效果。

方法

6只成年比格犬双侧拔除下颌第四前磨牙。在两侧远中牙槽窝即刻植入种植体,并制备标准化的颊侧骨缺损(高5mm,宽3 - 2mm)。所有缺损均填充缓慢吸收的马异种骨移植物,并覆盖可吸收的心包膜。在试验部位,用钛钉将膜固定于根尖方向,而对照部位不进行固定。愈合3个月后,进行组织形态计量学分析。

结果

试验部位(钛钉组)颊侧牙槽嵴垂直骨增量为3.2mm,对照部位(无钛钉组)为2.9mm(P>0.754)。在骨与种植体接触(BIC)方面未发现显著差异。然而,与无钛钉组相比,钛钉组的残余移植颗粒更靠近冠方(P = 0.021)。形态计量学分析显示两组内新骨形成相似,但钛钉组的残余异种骨和软组织量更多。

结论

膜固定并未显著提高垂直骨增量,尽管钛钉组略高的骨增量(3.2mm对2.9mm)在美学敏感区域和骨结合方面可能具有临床意义,但它似乎限制了移植材料的根尖向迁移。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d1e/12387244/0e61543c0746/jfb-16-00281-g001.jpg

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