Implanting two kinds of bone substitutes into the sockets after wisdom tooth extraction to recover alveolar bone height / 中国组织工程研究

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 groupsBio-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.