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Published in: Oral and Maxillofacial Surgery 2/2007

01-04-2007 | Originalien

Kieferkammveränderungen nach Versorgung frischer Extraktionsalveolen mit polylactidvernetzten ß-TCP Wurzelreplikaten – eine histomorphometrische Tierstudie

Extraktionswundversorgung mit ß-TCP Replikaten

Authors: Daniel Rothamel, Frank Schwarz, Monika Herten, Gabriela Chiriac, Nima Pakravan, Martin Sager, Jürgen Becker

Published in: Oral and Maxillofacial Surgery | Issue 2/2007

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Zusammenfassung

Ziel der vorliegenden Studie war es, dimensionale Veränderungen des Kieferknochens nach Extraktionswundversorgung mit passgenauen ß-TCP Wurzelreplikaten im Vergleich zu nicht aufgefüllten Alveolen zu untersuchen. Bei insgesamt zehn Hunden wurde unmittelbar nach Entfernung des ersten Prämolaren ein passgenaues Wurzelreplikat aus polylactidvernetzten ß-TCP-Granula in die Alveole eingebracht. Unbehandelte Extraktionsalveolen der Gegenseite dienten als split-mouth-Kontrolle. Nach drei und sechs Monaten wurden jeweils fünf Tiere geopfert und die entsprechenden Kieferabschnitte histologisch und histomorphometrisch untersucht. Folgende Daten wurden erhoben: Differenz der Höhe der lingualen und bukkalen Alveolenwand; Breite der Alveolenwände und Gesamtknochenbreite 1, 3 und 5 mm unterhalb des jeweiligen Knochenkamms.
Die Heilung verlief unauffällig bei allen Tieren. Die Histologien der Drei-Monats-Proben zeigten ein gut abgrenzbares, geringer als die Umgebung mineralisiertes Knochengewebe innerhalb der Alveolen sowohl bei der Kontroll- als auch bei der Testgruppe. Es ließen sich in der Testgruppe kleinere Anteile bindegewebig organisierten Materials, aber keine Reste des Knochenersatzmaterials nachweisen. Nach sechs Monaten waren die Grenzen zwischen altem und neuem Knochen weitestgehend verschwommen. Die Histomorphometrie (Tabelle 1, 2, 3) zeigte bei keinem der Messparameter einen statistisch signifikanten Unterschied zwischen Test- und Kontrollgruppe (p > 0.05, Student's T-Test). Es ließ sich schlussfolgern, dass die Versorgung von Extraktionsalveolen mit diesem polylactidvernetzten TCP-Wurzelreplikat keinen Vorteil hinsichtlich eines Erhaltes der Kieferkammdimension zu haben scheint.
Tabelle 1
Mittelwerte und Standardabweichungen der Knochenkammhöhendifferenzen nach drei und sechs Monaten
 
3 Monate
6 Monate
 
RR
Kontrolle
p
RR
Kontrolle
p
Vertikale Differenz in mm
1,1 ± 1,1
1,3 ± 0,7
0,869
1,2 ± 0,3
1,2 ± 0,9
0,870
Tabelle 2
Mittelwerte und Standardabweichungen der Alveolenwandbreite nach drei und sechs Monaten 1, 3 und 5 mm infracrestal
   
3 Monate
6 Monate
   
RR
Kontrolle
p
RR
Kontrolle
p
Alveolenwandbreite
oral
1 mm
1,1 ± 0,2
1,2 ± 0,2
0,737
1,4 ± 0,2
1,4 ± 0,4
0,915
  
3 mm
1,7 ± 0,4
1,8 ± 0,2
0,780
2,0 ± 0,2
2,3 ± 0,1
0,219
  
5 mm
2,3 ± 0,6
2,3 ± 0,4
0,984
2,6 ± 0,3
2,6 ± 0,3
0,956
 
vestibulär
1 mm
1,3 ± 0,3
1,3 ± 0,1
0,902
1,3 ± 0,1
1,7 ± 0,6
0,216
  
3 mm
2,0 ± 0,3
2,3 ± 0,4
0,284
2,2 ± 0,2
2,3 ± 0,4
0,956
  
5 mm
2,6 ± 0,4
2,9 ± 0,2
0,122
2,7 ± 0,5
2,6 ± 0,4
0,734
Tabelle 3
Mittelwerte und Standardabweichungen der Gesamtknochenbreiten nach drei und sechs Monaten 1, 3 und 5 mm infracrestal
   
3 Monate
6 Monate
   
RR
Kontrolle
p
RR
Kontrolle
p
Gesamtknochenbreite
oral
1 mm
3,0 ± 0,2
2,6 ± 0,3
0,491
3,1 ± 0,1
3,4 ± 0,3
0,385
  
3 mm
3,6 ± 0,2
3,1 ± 0,4
0,521
3,6 ± 0,1
3,8 ± 0,2
0,689
  
5 mm
3,9 ± 0,2
3,5 ± 0,3
0,548
4,1 ± 0,3
4,2 ± 0,3
0,567
 
vestibulär
1 mm
2,9 ± 0,4
2,7 ± 0,2
0,758
2,9 ± 0,2
2,9 ± 0,7
0,981
  
3 mm
3,5 ± 0,3
3,3 ± 0,2
0,608
3,5 ± 0,3
3,6 ± 0,7
0,801
  
5 mm
3,9 ± 0,4
3,9 ± 0,2
0,929
4,0 ± 0,4
4,1 ± 0,9
0,824
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Metadata
Title
Kieferkammveränderungen nach Versorgung frischer Extraktionsalveolen mit polylactidvernetzten ß-TCP Wurzelreplikaten – eine histomorphometrische Tierstudie
Extraktionswundversorgung mit ß-TCP Replikaten
Authors
Daniel Rothamel
Frank Schwarz
Monika Herten
Gabriela Chiriac
Nima Pakravan
Martin Sager
Jürgen Becker
Publication date
01-04-2007
Publisher
Springer-Verlag
Published in
Oral and Maxillofacial Surgery / Issue 2/2007
Print ISSN: 1865-1550
Electronic ISSN: 1865-1569
DOI
https://doi.org/10.1007/s10006-007-0050-z

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