Implanting two kinds of bone substitutes into the sockets after wisdom tooth extraction to recover alveolar bone height

doi:10.3969/j.issn.2095-4344.0057

Abstract

Abstract:

BACKGROUND: Bio-Oss bone substitutes have been shown to prevent bone resorption by slowing bone resorption, reducing bone resorption, and restoring the height of the alveolar ridge. However, most clinical studies focus on the efficacy within 1-3 months.

OBJECTIVE: To compare the effects of two kinds of bone substitutes on the height of alveolar ridge and the periodontal tissue health status after implantation into the extraction socket of the wisdom tooth.

METHODS: Forty patients with impacted mandibular teeth were randomly divided into two groups: Bio-Oss Collagen material was implanted in experimental group (n=20), and Bio-Oss bone replacement materials in control group (n=20). Cone-beam CT was retrospectively reviewed at 1, 3 and 12 months after implantation. Alveolar bone height, bone changes and the second molars mobility were examined. Meanwhile, healing status of tooth extraction and gingival mucosa as well as the material spills were observed.

RESULTS AND CONCLUSION: (1) At 1 month after implantation, the gingival mucosa of both groups healed well without swelling. There was no spillover in the experimental group, while there were two cases of bone material spill in the control group. No tissues generated in the extraction socket and tooth loosening was observed in both groups. (2) At 3 months after implantation, the materials gradually degraded with no swelling and with generation of partial bone tissues in the experimental group, and the tooth mobility was improved. In the control group, there was also no swelling in the gums, and the materials degraded partially, but there was no presence of new bone and no improvement in the tooth mobility. (3) At 12 months after implantation, there was no swelling in the gums of the experimental group, obvious new bone tissues formed in the second molar with the presence of bone trabecula. The new bone tissues were integrated with the surrounding bone tissues. The crest of the alveolar ridge was located about 3 mm below the enamel cementum, the tooth mobility was restored to the level before extraction, and the chewing function recovered. In the control group, there was no swelling in the gums, and new bone tissues formed in the distal part of the molar, but the trabecular arrangement was not aligned. The crest of the alveolar was located about 3 mm below the enamel cementum, the tooth mobility returned to the pre-extraction level, and the chewing function was normal. (4) The height of the alveolar bone at 1 and 3 months after implantation was significantly higher in the experimental group than the control group (P < 0.01), while there was no significant difference between the two groups at 12 months after implantation. To conclude, implantation of Bio-Oss Collagen immediately after removal of the impacted wisdom tooth of the mandible is beneficial to alveolar bone height and bone quality recovery, and significantly improves the periodontal health of the second molar, but the long-term effect needs further observation.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

Key words: Bone Transplantation, Periodontium, Alveolar Bone Loss, Molar, Third, Tissue Engineering

CLC Number:

R318

Li Yi-dan, Xu Nuo, Li Yue-ling, Yu Ming, Chen Jie, Li Xiao-jie. Implanting two kinds of bone substitutes into the sockets after wisdom tooth extraction to recover alveolar bone height[J]. Chinese Journal of Tissue Engineering Research, 2018, 22(6): 846-851.

Figures/Tables 3

References

[1]Peng KY,Tseng YC,Shen EC,et al.Mandibular second molar periodontal status after third molar extraction.J Pefiedontol. 2001;72(12):1647-1651．

[2]Kan KW,Liu JK,Lo EC,et al.Residual periodontal defects distal to the mandibular second molar 6-36 months after impacted third molar extraction.J Clin Periodontol. 2002;29(11): 1004-1011．

[3]牟淋,张敏.Bio-gide膜与Bio-oss骨代材料在引导骨组织再生术中的应用[J].国外医学:口腔医学分册,2004,31(增刊):156-158.

[4]黄桂林,程贤书,姜群,等.智齿拔除后羟基磷灰石恢复牙槽骨高度的临床研究[J].口腔颌面外科杂志,2005,15(4):357-359.

[5]Jensen SS,Aaboe M,Pinholt EM,et al.Tissne reaction and material characteristics of fur bone substitutes.Int J Oral Maxillofac Implants.1996;11:55-66.

[6]王建,胡秀莲,林野.Bio-oss和Bio-oss骨胶原保持牙槽骨量的临床研究[J].现代医学杂志,2009,23(1): 4-6.

[7]陈志方,叶茂昌,丁晓红,等.Bio-oss／rhBMP-2复合体修复异种再植牙周围骨缺损的实验研究[J].实用口腔医学杂志, 2007, 23(5):644-646.?

[8]陶安军,杨细虎,范广宇,等.引导再生术用于下颌第三磨牙拔除后牙槽骨再生的疗效评估[J].口腔医学,2016,36(11):1017-1019.

[9]Araújo M,Linder E,Wennström J,et al.The influence ofBio-osscollagenon healing of an extraction socket: an experimental study in the dog.Int J Periodontics Restorative Dent.2008;(2):123-135.

[10]李景辉,杨瑛,张方明.应用位点保存技术预防拔牙后牙槽骨吸收的临床疗效观察[J].临床和实验医学杂志, 2016,15(8):816-818?

[11]Zhang DZ,Xiao WL,Zhou R,et al.Evaluation of bone height and bone mineral density using cone beam computed tomo- graphy after secondary bone graft in alveolar cleft.J Craniofac Surg. 2015;26(5):1463-1466.

[12]贾赛雄,杜水红,欧春培,等.Bio-Oss骨粉复合BMP-2及VEGF修复大鼠胫骨缺损的实验研究[J].临床与实验医学杂志, 2015, 14(5):349-352.

[13]刘进,郭鑫.正畸治疗中磨牙的拔除和保留(二十四)-保留28个牙齿的设计理念[J].临床口腔医学杂志,2007,23(11):699-701. ?

[14]李伯友,苏铭扬,李阳,等. CGF联合骨代用品及口腔修复膜在颌骨囊肿手术中的应用[J].临床口腔医学杂志, 2016,32(8): 476-478

[15]Tang Y,Wu X,Lei W,et al.TGF-betal-induced migration of bonemesenchymal stem cells couples bone resorption with formation.J Natmed.2009;15(7):757-765.

[16]Carter K,Worthington S.Predictors of third molar im- paction: a systematic review and meta-analysis. J Dent Res. 2016; 95(3):267-276.

[17]Rakhshan V.Common risk factors for postoperative pain following the extraction of wisdom teeth.J Korean Assoc Oral Maxillofac Surg.2015;41(2):59-65.

[18]杜丽珍.下颌智齿阻生对邻牙牙体牙周组织健康的影响[J].临床医药实践,2011,20(8):587-589.

[19]Kim YK,Yun PY,Um IW,et al.Alveolar ridge preservation of an extraction socket using autogenous tooth bone graft material for implant site development: prospective case series.J Adv Prosthodont. 2014;6(6):521-527.

[20]Kim JW,Kim SJ,Kim MR.Leucocyte-rich and platelet-rich fibrin for the treatment of bisphosphonate-related osteonecrosis of the jaw: a prospective feasibility study.Br J Oral Maxillofac Surg.2014;52(9):854-859.

[21]胡申琳,吴友农,唐卫容,等.第三磨牙萌出情况的全景片分析[J].口腔生物医学,2010,6(2):84-87.

[22]黄国伟,庄浩,沈海平.拔牙位点保存技术在口腔种植临床的应用[J].上海口腔医学,2014,23(3):354-355.

[23]高朵朵.富自体生长因子纤维蛋白凝胶(膜)促进拔牙创愈合的临床研究[D].河北医科大学,2015.

[24]Ozgul O.Efficacy of platelet rich fibrin in the reduction of the pain and swelling after impacted third molar surgery: Randomized multicenter split -mouth clinical trial.Head Face Med.2015;11(1): 37.

[25]Lanzm RP,Langer R,Chixk W.principle of tissue engineering : Bone and cartikage reconstruilage rcconstuetion.J Acadpress. 1996;12(2):619-652.

[26]Kim BS,Mooney DJ.Development of biocompatible synthetic extrace-llularmatric for tissue engineerin.J Trends Biotechnol. 1998;16(5):224.

[27]Beresford JN,Bennett JH,Devlin C,et al.Evidence for an inverserela-tionship betweent the differentiation of adipocytic and osteogenic cellsin rat marrow stromal cell cultures.J Cell Sci.1992;102(2):341.

[28]Wakitani S,Goto T,Young RG,et al.Repair of large full thickhessar-ticular cartilage defects with allografts arti cular chondrocytes embedded-din a collagen Gel.J Tissue Eng. 1998;4(4):429-434.

[29]龚仁国,阙佳佳,罗纯锐,等.CGF在预防下颌阻生第三磨牙拔除术后并发症中的应用[J].成都医学院学报, 2016,11(1):82-84.

[30]王世惟,万蕾蕾,宋萌.Bio-oss 在颌骨囊肿术后缺损中的应用[J].中国口腔颌面外科杂志,2008,6(5):383-385.

[31]AntonelloGde M,Torres do Couto R,Giongo CC,et al.Evaluation of the effects of the use of platelet-rich plasma (PRP) on alveolar bone repair following extraction of impacted third molars: prospective study.J Craniomaxillofac Surg.2013; 41(4):70-75.

[32]麦昱颖,武辉煌,麦志松,等.磷酸钙骨水泥与聚乳酸-羟基乙酸微球复合物用于拔牙位点骨质保存的动物实验[J].中华口腔医学杂志,2014,49(3):180-183.

[33]Uyan?k LO,Bilginaylar K,Etikan ?.Effects of platelet-rich fibrin and piezosurgery on impacted mandibular third molar surgery outcomes.Head Face Med.2015;11:25.

[34]Célio-Mariano R,de Melo WM,Carneiro-Avelino C.Com- parative radiographic evaluation of alveolar bone healing associated with autologous platelet-rich plasma after im- pacted mandibular third molar surgery.J Oral Maxillofac Surg. 2012;70(1):19-24.

[35]Mozzati M,Gallesio G,Ullio L,et al.Patient-based as- sessment of tooth extraction with ultrasonic dental surgery.J Craniofac Surg.2014;25(6):2081-2083.

[36]高秀秋,程焕芝,孙良玉.Bio-Oss骨粉混合PRF修复牙周骨缺损的临床观察[J].医学与哲学,2015,36(10):32-33.

[37]Leonardi Dutra K,Haas L,Porporatti AL,et al.Diagnostic Accuracy of Cone-beam Computed Tomog- raphy and Conventional Radiography on Apical Periodon- titis: A Systematic Review and Meta-analysis.J Endod. 2016;42(3): 356-364.

[38]黄桂林,程贤书,姜群,等.牙拔除后羟基磷灰石恢复牙槽骨高度的临床研究[J].口腔颌面外科杂志, 2005,15(4):357-359.

[39]Ryana HK,Srinath R,Prakash S.Surgical Re-en-try of an Intentionally Replanted Periodontally Compromised Tooth Treated with Platelet Rich Fib- rin (PRF): Hopeless to Hopeful. J Clin Diagn Res. 2016;10(6):ZD01-4.