RESUMO
The purpose of this study was to evaluate the preservation of alveolar dimensions in human fresh extraction sockets filled with a composite bovine bone graft by means of design of single-blind randomized clinical trial. Forty participants had monoradicular teeth extracted (one teeth in each participant), and after were randomly divided into 2 groups: individuals whose fresh sockets were filled with the composite heterologous bone graft (Biomaterial Group), or with blood clot (Control Group). After extraction, the fresh sockets were measured at their greatest mesiodistal (MD) and bucco-lingual/palatal (BL/P) distance. Primary closure of the soft tissue was performed with a fibro-mucosal plug. After 120 post-operative days, the re-entry procedure was performed and the largest MD and BL/P measurements were again obtained to calculate the remodeling of the alveolar bone measured in percentage. In the biomaterial group, a percentage reduction of 1.62% and 3.29% in the MD and BL/P dimensions was observed 120 days after the extractions, whereas a reduction of 4.97% and 7.18% in the MD and BL/P dimensions occurred in the control group. There was a statistically significant difference (p<0.05) between the two groups for the bucco-palatal and mesiodistal measurements in the maxilla. In view of the results obtained, it can be concluded that composite bovine bone graft limited but did not impede alveolar bone remodeling.
Assuntos
Perda do Osso Alveolar/prevenção & controle , Remodelação Óssea/fisiologia , Substitutos Ósseos/farmacologia , Adolescente , Adulto , Animais , Bovinos , Humanos , Pessoa de Meia-Idade , Método Simples-Cego , Extração Dentária , Alvéolo Dental , Resultado do Tratamento , Cicatrização/fisiologiaRESUMO
Abstract The purpose of this study was to evaluate the preservation of alveolar dimensions in human fresh extraction sockets filled with a composite bovine bone graft by means of design of single-blind randomized clinical trial. Forty participants had monoradicular teeth extracted (one teeth in each participant), and after were randomly divided into 2 groups: individuals whose fresh sockets were filled with the composite heterologous bone graft (Biomaterial Group), or with blood clot (Control Group). After extraction, the fresh sockets were measured at their greatest mesiodistal (MD) and bucco-lingual/palatal (BL/P) distance. Primary closure of the soft tissue was performed with a fibro-mucosal plug. After 120 post-operative days, the re-entry procedure was performed and the largest MD and BL/P measurements were again obtained to calculate the remodeling of the alveolar bone measured in percentage. In the biomaterial group, a percentage reduction of 1.62% and 3.29% in the MD and BL/P dimensions was observed 120 days after the extractions, whereas a reduction of 4.97% and 7.18% in the MD and BL/P dimensions occurred in the control group. There was a statistically significant difference (p<0.05) between the two groups for the bucco-palatal and mesiodistal measurements in the maxilla. In view of the results obtained, it can be concluded that composite bovine bone graft limited but did not impede alveolar bone remodeling.
Resumo O objetivo deste estudo foi avaliar em humanos a manutenção do volume em alvéolos frescos preenchidos por osso integral de origem bovina por meio de um estudo clínico randomizado com monocegamento. Quarenta dentes uni radiculares foram extraídos em 40 pacientes (um dente em cada participante), e apos estes pacientes foram divididos aleatoriamente em 2 grupos: indivíduos que tiveram o alvéolo fresco preenchido por osso integral de origem bovina (Grupo Biomaterial) ou por coagulo sanguíneo (Grupo Controle). Apos a exodontia os alvéolos foram medidos em suas maiores distancias mesio-distal (MD) e vestíbulo lingual/palatina (VL/P) por meio de compasso de ponta seca. O fechamento primário dos alvéolos foi realizado com um tampão fibromucoso. Apos 120 dias pós-operatórios durante o procedimento de reabertura foram obtidas novamente as maiores medidas MD e VL/P para calcular em porcentagem o nível de remodelação do osso alveolar. No grupo biomaterial observou-se uma redução em porcentagem de 1,62% e 3,29% nas medidas MD e VL/P 120 dias apos as extrações, enquanto no grupo controle houve uma redução de 4,97% e 7,18% nas medidas MD e VL/P no mesmo período. Houve diferença estatisticamente significante (p<0,05) entre os dois grupos para as medidas vestíbulo/palatina e mesiodistal na maxila. Diante dos resultados obtidos conclui-se que o osso integral de origem bovina limitou, mas não impediu a remodelação óssea alveolar.
Assuntos
Humanos , Animais , Adolescente , Adulto , Pessoa de Meia-Idade , Perda do Osso Alveolar/prevenção & controle , Remodelação Óssea/fisiologia , Substitutos Ósseos/farmacologia , Extração Dentária , Cicatrização/fisiologia , Bovinos , Método Simples-Cego , Resultado do Tratamento , Alvéolo DentalRESUMO
O objetivo deste estudo foi avaliar em humanos a manutenção do volume alveolar após o preenchimento do alvéolo, pós exodontia, com osso composto de origem bovina. Materiais e Métodos: Foram triados e selecionados 43 indivíduos, de ambos os gêneros, de etnias, entre 18 e 45 anos com padrão de saúde ASA I. Critérios de Exclusão foram: idade incompatível, comprometimento sistêmico, lesões periapicais ou periodontais, reabsorção de uma ou mais paredes alveolares, gestantes e fumantes. Foram executadas 43 extrações de dentes unirradiculares, e os indivíduos foram divididos em 2 grupos: grupo de indivíduos enxertados (GE) e grupo controle (GC), sendo: GE=13 maxila e 10 mandíbula GC= 10 maxila e 10 mandíbula. Em ambos os grupos GE e GC, após exodontia minimamente traumática os alvéolos foram curetados e medidos nas maiores distâncias MD (mésio distal) e VL/P (vestíbulo lingual/palatina). A síntese no GC foi realizada com um tampão fibromucoso obtido da região retro molar superior. No grupo GE foi feito o preenchimento com enxerto ósseo de origem bovina e a síntese realizada com tampão fibromucoso obtido da região retro molar superior. Após 120 dias do reparo alveolar, foram realizadas as cirurgias de reabertura e as medidas foram obtidas sempre obedecendo a maior distancia entre as paredes MD e VL/P. Resultados : A média total das medidas obtidas no diâmetro MD e VL/P dos grupos GE e GC na maxila e na mandíbula (N=43). No GC (N=19) para as medidas MD verificou-se a diferença de 4,97% e 7,01% nas medidas VL/P, sendo para o GE (N=24) para as medidas verificou-se a diferença de 1.62% MD e 3,29% nas medidas VL/P. Somente entre as variáveis analisadas, Local VP, GC, Maxila, houve diferença estatística significante (p<0,05). Conclusão: É possível concluir que: a remodelação no sentido vestíbulo lingual é mais acentuada na maxila em relação a mandíbula e que o osso composto limita mas não impede a remodelação alveolar
The objective of this study was to evaluate the maintenance of human alveolar volume after filling of the alveoli, after tooth extraction, bone composed of bovine origin. Materials and Methods: Were screened and selected 43 individuals of both genders, ethnicities, ages 18 to 45 years with health standard ASA I. Exclusion criteria were: age inconsistent, systemic involvement, periodontal or periapical lesions, one or more resorption of alveolar walls, and pregnant smokers. Extractions were performed 43 single-rooted teeth, and individuals were divided into two groups: individuals grafted (EG) and control group (CG), as follows: GE = 13 maxillary and 10 mandibular GC = 10 maxillary and 10 mandibular. In both groups, GE and GC, after extraction minimally traumatic and curettage of the wells were measured at greater distances MD (mesial and distal) and VL / P (vestibule lingual / palatal). The synthesis was performed with GC in a buffer fibromucoso obtained retro molar region. In the GE group was made filling with bone graft of bovine origin and synthesis was carried out with buffer fibromucoso obtained from the retro molar region. After 120 days of alveolar repair, the openings were made and measurements were obtained always obeying the greatest distance between the walls and VL MD / P. Results: The mean total diameter measurements obtained in the MD and BL / P of SG and CG in the maxilla and mandible (N = 43). In the CG (N = 19) for measures MD verified the difference of 4.97% and 7.01% in measures VL / P, being for the GE (N = 24) for measures verified the difference of 1.62% and 3.29% in the MD measures VL / P. Only among the variables analyzed, Local VP, GC, jaw, there was a statistically significant difference (p <0.05) Conclusion: It is possible to conclude that remodeling in buccal lingual is more pronounced in the maxilla and mandible relative to the bone but not limited compound prevents alveolar remodeling