Histologic Outcomes of the Use of Different Biomaterials for Socket Regeneration in Fresh Extraction Sockets: A Split-Mouth Randomized Clinical Trial.

IF 1.7 4区 医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE International Journal of Oral & Maxillofacial Implants Pub Date : 2022-09-01 DOI:10.11607/jomi.9422
Yasmina Guadilla, Lorena Benito-Garzón, Norberto Quispe-López, Javier Montero
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Abstract

Purpose: To analyze the quality of bone regeneration in fresh sockets using four different materials at different time points.

Materials and methods: A split-mouth randomized clinical trial was designed to evaluate the histologic and histomorphometric characteristics of 82 fresh sockets from 30 patients. One socket per patient healed spontaneously (control), and at least one fresh socket was grafted with a material chosen randomly from a sealed envelope: plateletrich growth factor (PRGF; n = 20 sites), PRGF + autologous bone (n = 9 sockets), autologous bone (n = 10 sites), or PRGF + demineralized freeze-dried bone allograft (DFDBA; n = 13). Biopsy specimens were taken at different time points divided into three assessment groups: short duration (2 to 4 months), intermediate duration (5 to 6 months), and long duration (7 to 12 months). The histologic findings were assessed to quantify the trabeculae pattern, the degree of mineralization, and the quality of bone regeneration.

Results: A total of 26 patients with 73 sockets completed the study. Mineralization after a short duration was found to be significantly higher among sockets treated only with autologous bone (47.3% ± 3.6%) or with PRGF+autologous bone (45.1% ± 13.6%). During the intermediate time point, this difference was not observed; also, the control sites were found to have the highest amount of mineralization (37.7% ± 14.9%). After a long duration of wound healing, the PRGF+DFDBA group had the greatest percentage of mineralized tissue (54.7% ± 28.7%), which was significantly higher than the sites treated only with PRGF (30.0% ± 13.2%).

Conclusion: From a histologic point of view, the use of autologous graft with or without PRGF seems to be the best strategy for socket regeneration within a short period of time (2 to 4 months). However, the application of PRGF alone inside fresh sockets may interfere with normal bone healing compared with control sites healed spontaneously.

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使用不同生物材料进行新鲜拔牙槽座再生的组织学结果:一项裂口随机临床试验。
目的:分析四种不同材料在不同时间点的新鲜牙槽骨再生质量。材料与方法:采用随机临床试验的方法,对30例患者的82个新鲜牙槽进行组织学和组织形态学分析。每个患者有一个眼窝自发愈合(对照组),并且至少有一个新鲜眼窝移植了从密封信封中随机选择的材料:富血小板生长因子(PRGF;n = 20个位点),PRGF +自体骨(n = 9个位点),自体骨(n = 10个位点),或PRGF +脱矿冻干同种异体骨移植(DFDBA;N = 13)。在不同时间点取活检标本,分为三个评估组:短期(2 ~ 4个月)、中期(5 ~ 6个月)和长期(7 ~ 12个月)。对组织学结果进行评估,以量化小梁模式、矿化程度和骨再生质量。结果:26例患者共73个牙槽完成了研究。仅用自体骨或PRGF+自体骨治疗的牙槽骨在短时间内矿化率明显更高(47.3%±3.6%)。在中间时间点,没有观察到这种差异;对照区矿化度最高(37.7%±14.9%)。经过较长时间的创面愈合,PRGF+DFDBA组矿化组织比例最高(54.7%±28.7%),显著高于单纯PRGF组(30.0%±13.2%)。结论:从组织学角度来看,在短时间内(2 - 4个月),使用自体移植物(含或不含PRGF)似乎是窝再生的最佳策略。然而,与自然愈合的对照部位相比,在新鲜的骨窝内单独应用PRGF可能会干扰正常的骨愈合。
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来源期刊
CiteScore
3.30
自引率
5.00%
发文量
115
审稿时长
6 months
期刊介绍: Edited by Steven E. Eckert, DDS, MS ISSN (Print): 0882-2786 ISSN (Online): 1942-4434 This highly regarded, often-cited journal integrates clinical and scientific data to improve methods and results of oral and maxillofacial implant therapy. It presents pioneering research, technology, clinical applications, reviews of the literature, seminal studies, emerging technology, position papers, and consensus studies, as well as the many clinical and therapeutic innovations that ensue as a result of these efforts. The editorial board is composed of recognized opinion leaders in their respective areas of expertise and reflects the international reach of the journal. Under their leadership, JOMI maintains its strong scientific integrity while expanding its influence within the field of implant dentistry. JOMI’s popular regular feature "Thematic Abstract Review" presents a review of abstracts of recently published articles on a specific topical area of interest each issue.
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