透明质酸对预制CAD CAM骨块的有效性：一项裂口研究

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

Clinical Implant Dentistry and Related Research Pub Date : 2025-04-15 DOI:10.1111/cid.70035

Mohamed Hamdy Helal, Mona S. Sheta, Aya Anwar Alsherif, Mai Atef Hassan, Moustafa Nabil Aboushelib, Rehab F. Ghouraba

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引用次数: 0

摘要

牙槽嵴增强术是修复骨体积最常用的治疗方法之一。各种颗粒形式的产品都有局限性，特别是在控制预期体积增益方面。预制的计算机辅助设计和计算机辅助制造（CAD-CAM）异体骨块是一个很好的选择。材料与方法采用裂口随机临床试验方法，将10例双侧后萎缩下颌骨患者（20侧）随机分为两组，分配比例为1:1。组1：采用透明质酸水合的预制CAD-CAM同种异体骨块增强骨脊，组2采用生理盐水水合。盲法仅限于患者和负责数据分析的研究者（双盲）。移植手术6个月后，进行核心活检进行组织学分析，并将植入物插入增强的脊中。使用CBCT放射学评估骨增加量。结果两组牙脊CBCT均显示骨增重成功。ⅰ组平均骨增重（3.975±0.31）显著高于ⅱ组（2.497±0.66）。组织学上，两组均表现为骨整合和新骨形成，以ⅰ组为佳。I组VEGF、OPN、Cox 2表达明显高于II组。组织形态计量学分析显示，I组的新骨形成表面积明显高于II组(p值<；0.001)。免疫组化染色结果显示，ⅰ组（15.04±0.47）与ⅱ组（11.41±0.54）差异有统计学意义。结论在本研究的局限性内，在预制CAD-CAM同种异体骨块中添加HA可增强其成骨性能，并保证移植物与植入体的充分融合。该临床试验在参与者招募和随机化之前未进行注册（https://clinicaltrials.gov/study/NCT06395818）。

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The Effectiveness of Hyaluronic Acid on Prefabricated CAD CAM Bone Blocks for Ridge Augmentation: A Split Mouth Study

Introduction

Alveolar ridge augmentation has been one of the most accepted treatments for restoring bone volume. Various products are available in particle forms, which have limitations, especially related to controlling the expected volume gain. A prefabricated computer-aided design and computer-aided manufacturing (CAD-CAM) allogenic bone block could provide a good alternative.

Materials and Methods

A split-mouth randomized clinical trial included 10 patients with the bilateral posterior atrophic mandible (20 sides), who were randomly assigned to two groups with an allocation ratio of 1:1. Group I: the ridge was augmented using prefabricated CAD-CAM allogenic bone block hydrated using hyaluronic acid, and group II was hydrated using saline. Blinding was limited to the patients and the investigator responsible for data analysis (double blinding). Six months after grafting surgery, a core biopsy was taken for histological analysis, and implants were inserted into the augmented ridge. The amount of bone gain was evaluated radiographically using CBCT.

Results

All ridges in both groups revealed a successful bone gain in CBCT. However, the mean bone gain in group I (3.975 ± 0.31) was significantly higher than in group II (2.497 ± 0.66). Histologically, both groups showed osteointegration and new bone formation, with group I being superior. VEGF, OPN, and Cox 2 expressions were more intense in group I than in group II. The histomorphometric analysis revealed that group I had a considerably higher surface area of new bone formation than group II (p-value < 0.001). Immunohistochemical staining for VEGF revealed a significant difference between groups I (15.04 ± 0.47) and II (11.41 ± 0.54).

Conclusion

Within the limitations of this study, the addition of HA to prefabricated CAD-CAM allogenic block enhanced its osteogenic properties and guaranteed adequate integration of the graft for implant insertion.

Trial Registration

This clinical trial was not registered before the participants' recruitment and randomization (https://clinicaltrials.gov/study/NCT06395818).

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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.