The Imaging Study Of The Application Of Demineralized Dentin Matrix To Site Preservation And Bone Augmentation During Implantation

OBJECTIVE: To study the bone changes of demineralized dentin matrix used for site preservation after tooth extraction and implantation during the same period of GBR surgery.Materials and methods: From January 2019 to June 2020 to the fourth affiliated hospital of Nanchang University,selected patients who met the inclusion criteria,a total of 16 patients,of which 11 were in the site preservation surgery group,and a total of 13 site preservation areas;5 people in the bone augmentation surgery group during the same period of implantation,10 implants were implanted.Site preservation surgery and implantation and bone augmentation surgery performed by the same surgeon.Before surgery(T0),postoperative day(T1)and half a year after surgery(T2)for site preservation surgery,CBCT was taken to measure the mesial bones.Height,distal bone height,buccal bone height,lingual bone height,alveolar ridge width and bone defect depth;the mesiodistal bone height and bone defect depth are measured based on the meso-distal enamel-cementum boundary The connection line is the baseline(baseline root is-,coronal side is +);the buccal and lingual bone height and bone width are measured based on the occlusal surface of the antagonist teeth as the baseline(baseline root is-,and crown is +);For those undergoing bone augmentation surgery at the same time,take CBCT on the day(T1)and half a year(T2)after the operation,and measure the buccal-lingual bone height,buccal-lingual bone wall thickness,bone width,and mesio-distal marginal bone height,using SPSS 24.0 software for statistical analysis.Results:In the site preservation group,the mesial bone heights at T0,T1,and T2 were-4.94±2.54 mm,-3.61±2.18 mm,and-3.63±2.73 mm,respectively.There was a statistical difference in mesial bone height between T1 and T0.Academic significance(P<0.05);when T2 is compared with T0,the difference is statistically significant(P<0.05);when T2 is compared with T1,the difference is not statistically significant(P>0.05).The height of the distal bone in the T0,T1,and T2 periods were-4.85±1.97 mm,-2.80±1.70 mm,and-3.61±2.17 mm,respectively.There was a statistically significant difference in the height of the distal bone at T1 compared with T0(P<0.05).);when T2 was compared with T0,the difference was not statistically significant(P>0.05);when T2 was compared with T1,the difference was not statistically significant(P>0.05).The buccal bone heights at the T0,T1,and T2 periods were-11.82±4.03 mm,-11.61 ± 4.38 mm,and-11.25 ± 4.16,respectively.There was no significant difference in the buccal bone heights at the T0,T1,and T2 periods(P> 0.05).The height of the lingual bone during T0,T1,and T2 were-12.47±4.58 mm,-12.97±4.66 mm,and-11.94 ±4.42 mm,respectively.There was no statistically significant difference in the height of the lingual bone during T0,T1,and T2(P >0.05);The bone defect depths at T0,T1,and T2 were-12.49 ± 3.98 mm,-5.39 ±3.89 mm,and-5.28 ± 4.29 mm,respectively.There was a statistically significant difference in bone defect depth between T1 and T0(P<0.05);The difference between T2 and T0 was statistically significant(P<0.05);when T2 was compared with T1,the difference was not statistically significant(P>0.05).The bone widths at T0,T1,and T2 were 9.99 ± 2.78 mm,8.92 ± 3.42 mm,and 7.63 ± 2.96 mm,respectively.There was no significant difference in bone width between T1 and T0(P>0.05);when T2 was compared with T0,The difference was statistically significant(P<0.05);when T2 was compared with T1,the difference was not statistically significant(P>0.05).In the site preservation group,according to the number of remaining alveolar socket bone walls after tooth extraction,they were divided into 4-wall group and3-wall group.In the 4-wall group and 3-wall group,the bone levels of T1-T0,T2-T0,and T2-T1 were different The value difference was not statistically significant(P>0.05).In the bone augmentation group at the same time of implantation,the thickness of buccal bone wall,lingual bone wall thickness,buccal bone height,hyoid bone height,bone width,and distal bone height decreased by 0.68±0.65 mm and 1.09 at T2 compared with T1.±0.67 mm,0.90±0.65 mm,0.79±0.54 mm,0.86±1.42 mm,1.31 ± 0.50 mm,0.27 ± 0.49 mm,the difference was not statistically significant(P>0.05).The mesial bone heights at T1 and T2 were 3.69±1.67 mm and 2.38±1.47 mm,respectively.Compared with T1,the mesial bone height was reduced by0.27±0.49 mm,and the difference was statistically significant(P>0.05).During T2,all 10 implants achieved osseointegration,and the implant success rate was 100%.Conclusion:1.The application of demineralized dentin matrix in site preservation surgery has achieved good site preservation effects,and the effect of applying to the preservation area of 4-wall alveolar and 3-wall alveolar cavity is similar;2.Application of demineralized dentin matrix The bone augmentation surgery at the same time as the implantation can effectively maintain the bone contour.