牙槽嵴保留是否减少了窦底抬高的需要:与自发愈合的比较研究。

Elias Jean-Jacques Khoury, Keyvan Sagheb, Bilal Al-Nawas, Jochem König, Eik Schiegnitz
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引用次数: 0

摘要

前言上颌后牙区萎缩的特点是垂直骨量减少,因此植入种植体变得非常困难。为了解决骨量不足的问题,通常需要进行上颌窦提升等增量手术。本研究旨在探讨与拔牙后伤口自然愈合相比,使用牛骨替代物和猪胶原膜进行牙槽嵴保存是否能显著减少上颌窦提升术的需求:在这项比较临床研究中,40 名总共需要拔牙 53 次的患者被分配到以下两组中的一组:使用牛骨替代材料(Straumann® XenoFlex)和猪胶原蛋白膜(Jason® 膜)的试验组,或自发窝愈合的对照组。6 个月后,进行数字容积断层扫描,以制定种植计划:结果:对照组(n = 22 个拔牙部位)有 7 名患者进行了上颌窦提升增量手术,而试验组(n = 31 个拔牙部位)只有 4 名患者进行了上颌窦提升增量手术,这表明对照组患者对上颌窦增量手术的需求更高,但在统计学上没有差异,P 值为 0.05(P = 0.168)。在对照组中,拔牙前术前影像学测量的骨高度(中轴和远轴)平均值为 11.13 ± 2.12 毫米,而植入种植体后的术后骨高度平均值为 11.3 ± 2.17 毫米。而试验组的术前平均值为 11.78 ± 3.09 毫米,术后为 11.92 ± 2.79 毫米。统计分析显示,两组之间无明显差异(几率比 0.32;95% CI:0.08,1.26;P = 0.951)。对照组的种植体存活率为 100%,而试验组为 96.77%:在本研究的范围内,与自发愈合相比,在上颌后牙拔除后使用牛骨替代物和猪可吸收膜似乎可以减少对上颌窦增量的需求,尽管差异在统计学上并不显著。此外,与对照组相比,试验组的牙槽嵴保留使外部窦底抬高变得不必要。两组患者术前和术后放射线测量的骨高度变化无明显差异。
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Does alveolar ridge preservation reduce the need for sinus floor elevation: A comparative study to spontaneous healing.

Introduction: In cases of atrophy in the maxillary posterior region, characterized by reduced vertical bone volume, implant placement becomes challenging. Augmentation procedures like sinus lifts are often needed to address insufficient bone volume. This study aims to explore if alveolar ridge preservation, using a bovine bone substitute and a porcine collagen membrane, significantly decreases the need for sinus lifts compared to natural wound healing after tooth extraction.

Materials and methods: In this comparative clinical study, 40 patients requiring a total of 53 extractions were assigned to one of the following groups: a test group with bovine bone substitute material (Straumann® XenoFlex) and a porcine collagen membrane (Jason® membrane), or a control group with spontaneous socket healing. After 6 months, digital volume tomography was performed for implant planning.

Results: For seven patients from the control group (n = 22 extracted sites) sinus lift augmentations were performed while only four sinus lift procedures were performed in the test group (n = 31 extracted sites), indicating a higher need for sinus augmentation procedures in the control group, however not statistically different on a p value of 0.05 (p = 0.168). In the control group, the mean value of the radiographically measured bone height (mesial and distal) was 11.13 ± 2.12 mm preoperatively before tooth extraction, while it was 11.3 ± 2.17 mm postoperatively after implant placement. In contrast, the mean value in the test group was 11.78 ± 3.09 mm preoperatively and 11.92 ± 2.79 mm postoperatively. Statistical analysis revealed no significant difference between the two groups (odds ratio 0.32; 95% CI: 0.08, 1.26; p = 0.951). The implant survival rate in the control group was 100%, compared to 96.77% in the test group.

Conclusion: Within the limits of this study, the use of bovine bone substitute and a porcine resorbable membrane after tooth extraction in the posterior maxilla seems to reduce the need for sinus augmentation in comparison to spontaneous healing although the difference was not statistically significant. Additionally, the Alveolar Ridge Preservation in the test group made external sinus floor elevation unnecessary compared to the control group. The change in radiographically measured bone height pre- and postoperatively showed no significant difference between the two groups.

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