Moldable and Particulate Bone Material in Alveolar Ridge Preservation: A Multicenter Randomized Controlled Trial

IF 3.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research Pub Date : 2025-03-11 DOI:10.1111/cid.70011

Yiseul Choi, Jieun Cheong, Yoolbin Song, Jaeyeon Kim, Dae-Young Kang, Hyeon-Seong Ahn, Sanghoon Park, Marco Esposito, Hyun-Seung Shin, Wonse Park

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引用次数: 0

Abstract

Introduction

This study aimed to determine possible histological and radiological differences in alveolar ridge preservation (ARP), using moldable bone versus particulate bone.

Methods

After tooth extraction, 39 patients (40 teeth) were randomized (1:1) to receive ARP using moldable bone materials (SBX group) or particulate bone materials (PBX group). An absorbable collagen membrane was placed over the graft material and the surgical site was sutured. Cone-beam computed tomography was taken immediately and 5 months after ARP. Bone core samples from the implantation site were obtained for histomorphometric analysis 5 months after ARP.

Results

Forty-six patients were screened and 39 of them completed the study. However, one patient who received split-mouth treatment was excluded, resulting in data from 38 patients being analyzed. In radiological evaluation, the changes in midbuccal alveolar bone height at 5 months were −0.753 ± 0.112 and −1.018 ± 0.111 mm in the SBX group and PBX groups, respectively (F = 2.895; p = 0.098; mean difference [MD] 0.265; 95% confidence interval [CI] = −0.051 to 0.582). Changes in the horizontal ridge width were measured at three levels (−1, −3, and −5 mm) below the most coronal aspect of the crest and showed a decrease in both groups, with no significant differences between the groups. The percent new bone area of the SBX group (39.156 ± 2.505) was significantly different from that of the PBX group (22.749 ± 2.476) (F = 22.171; p < 0.001; 95% MD 16.407; CI = 9.333 to 23.481). The percent residual material area was significantly lower in the SBX group (8.973 ± 2.211) compared to the PBX group (15.633 ± 2.186), with an F-statistic of 4.687 and p-value = 0.037 (MD –6.660; 95% CI = −12.904 to −0.415). The percent connective tissue area was 49.743 ± 4.199 and 56.657 ± 4.151 for the groups (F = 1.401; p = 0.245; MD –6.914; 95% CI = −18.773 to 4.944), respectively.

Conclusion

Radiological and histological results showed that use of moldable bone can achieve similar ARP parameters as those achieved by particulate bone.

Trial Registration: Clinical Research Information Service No. KCT0009560. This randomized clinical trial was not registered before participant recruitment and randomization. (Date of registration: 21/06/2024. https://cris.nih.go.kr/cris/search/detailSearch.do?seq=27272&searchpage=L)

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可塑和颗粒骨材料在牙槽嵴保存中的应用：一项多中心随机对照试验

本研究旨在确定可塑骨和颗粒骨在牙槽嵴保存（ARP）方面可能的组织学和放射学差异。方法将拔牙后39例患者（40颗牙）按1:1的比例随机分为可塑骨材料组（SBX组）和颗粒骨材料组（PBX组）。将可吸收的胶原膜覆盖在移植材料上，缝合手术部位。即刻及术后5个月分别行锥形束计算机断层扫描。在ARP后5个月取植入部位的骨核样本进行组织形态学分析。结果筛选46例患者，39例完成研究。然而，有1名接受了口裂治疗的患者被排除在外，导致38名患者的数据被分析。放射学评价：5个月时，SBX组和PBX组的颊中牙槽骨高度变化分别为- 0.753±0.112和- 1.018±0.111 mm (F = 2.895；p = 0.098；平均差[MD] 0.265；95%置信区间[CI] = - 0.051 ~ 0.582)。水平脊宽的变化在冠状面以下的三个水平（- 1、- 3和- 5毫米）测量，两组均显示下降，组间无显著差异。SBX组新生骨面积百分比（39.156±2.505）与PBX组（22.749±2.476）差异有统计学意义(F = 22.171；p < 0.001；95% md 16.407；CI = 9.333 ~ 23.481)。SBX组的残留物质面积百分比（8.973±2.211）明显低于PBX组（15.633±2.186），f统计值为4.687，p值= 0.037 (MD -6.660；95% CI =−12.904 ~−0.415)。结缔组织面积百分比分别为49.743±4.199和56.657±4.151 (F = 1.401；p = 0.245；MD -6.914;95% CI =−18.773 ~ 4.944)。结论放射学和组织学结果表明，使用可塑骨可以获得与颗粒骨相似的ARP参数。试验注册：临床研究信息服务KCT0009560。该随机临床试验在参与者招募和随机化之前未注册。(注册日期：21/06/2024。https://cris.nih.go.kr/cris/search/detailSearch.do?seq=27272& searchpage = L)

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来源期刊

Clinical Implant Dentistry and Related Research 医学-牙科与口腔外科

CiteScore

6.00

自引率

13.90%

发文量

103

审稿时长

4-8 weeks

期刊介绍： The goal of Clinical Implant Dentistry and Related Research is to advance the scientific and technical aspects relating to dental implants and related scientific subjects. Dissemination of new and evolving information related to dental implants and the related science is the primary goal of our journal. The range of topics covered by the journals will include but be not limited to: New scientific developments relating to bone Implant surfaces and their relationship to the surrounding tissues Computer aided implant designs Computer aided prosthetic designs Immediate implant loading Immediate implant placement Materials relating to bone induction and conduction New surgical methods relating to implant placement New materials and methods relating to implant restorations Methods for determining implant stability A primary focus of the journal is publication of evidenced based articles evaluating to new dental implants, techniques and multicenter studies evaluating these treatments. In addition basic science research relating to wound healing and osseointegration will be an important focus for the journal.