| Abstract | Cilj istraživanja: Cilj istraživanja bio je ispitati kvalitativne i kvantitativne histološke promjene na bioptatima kosti šest mjeseci nakon očuvanja alveolarnog grebena injekcijskim bifaznim kalcijevim fosfatom (I-BKF) i anorganskom goveđom kosti (AGK). Ustroj studije: Randomizirana kontrolirana klinička studija. Ispitanici i metode: Nakon atraumatske ekstrakcije zuba, postupkom randomizacije, pacijenti su podijeljeni u ispitivanu skupinu i kontrolnu skupinu. Za očuvanje alveole u testnoj skupini koristio se I-BKF, dok se u kontrolnoj skupini koristila AGK. Nakon šest mjeseci cijeljenja, tijekom preparacije ležišta za dentalni implantat, trepan svrdlom uzorkovani su bioptati regenerirane kosti te proslijeđeni na kvalitativnu i kvantitativnu histološku analizu. Rezultati: Analizirano je ukupno 44 bioptata, 24 iz ispitivane skupine te 20 iz kontrolne. Jedan pacijent u ispitivanoj skupini odustao je od sudjelovanja u istraživanju. Patohistološke promjene pokazale su se jednakima u objema skupinama. Oba biomaterijala pokazala su dobru integraciju s okolnim tkivom te nisu uočeni znakovi upalne reakcije tkiva. Histomorfometrijska analiza pokazala je da nema značajne razlike u usporedbi srednjeg postotka novostvorene kosti [AGK: medijan 26,19 % (interkvartilnog raspona od 16,14 % do 39,21 %) vs. medijan I-BKF: 27,05 % (interkvartilnog raspona od 11,23 % do 35,95 %), P = 0,314, Mann Whitney U test] i rezidualnog biomaterijala [AGK: medijan 18,21 % (interkvartilnog raspona od 10,41 % do 28,78 %) vs. I-BKF: medijan 9,86 % (interkvartilnog raspona od 2,18 % do 17,06 %), P = 0,054 Mann Whitney U test] među skupinama. Međutim, u usporedbi srednjeg postotka mekog tkiva u analiziranim bioptatima, uočeno je da je srednji postotak mekog tkiva značajno veći u grupi gdje je korišten I-BKF u odnosu na grupu bioptata AGK [AGK: medijan 47,98 % (interkvartilnog raspona od 39,50 % do 63,15 %) vs. I-BKF: medijan 63,26 % (interkvartilnog raspona od 50,06 % do 73,30 %), P = 0,022, Mann Whitney U test]. Zaključak: Provedeno istraživanje prva je histološka evaulacija I-BKF-a na humanim bioptatima uzorkovanim šest mjeseci nakon očuvanja alveole te njegova usporedba s AGK-om. Oba biomaterijala pokazala su dobru ostekonduktivnost i biokompatibilnost s okolnim tkivom. Istraživanje je pokazalo da je korištenje I-BKF-a u očuvanju alveolarnog grebena sigurno te da rezultira zadovoljavajućom regeneracijom koštanog tkiva. |
| Abstract (english) | Objective: The aim of this study was to evaluate the qualitative and quantitative histological changes in bone biopsies six months after alveolar ridge preservation using injectable biphasic calcium phosphate (I-BCP) and anorganic bovine bone (ABB). Study design: A randomized controlled clinical trial. Participants and Methods: After atraumatic tooth extraction, patients were randomized into a test group and a control group. To preserve the extraction socket, the test group received I-BCP, while the control group received ABB. After a six-month healing period, bone biopsies of the regenerated bone were taken with a trephine bur during implant bed preparation. The bone biopsies were subjected to qualitative and quantitative histological analysis. Results: A total of 44 bone biopsies were analyzed: 24 in the test group and 20 in the control group. One patient decided to withdraw from the study. Pathohistological changes were comparable in both groups. Both biomaterials showed good integration into the surrounding tissue, and no signs of inflammatory tissue reaction were observed. Histomorphometric analysis showed that there was no significant difference in the comparison of the mean percentage of newly formed bone [ABB: 26,19% (interquartile range from 16,14% to 39,21%) vs. I-BCP: 27,05% (interquartile range from 11,23% to 35,95%), P = 0,314, Mann Whitney U test] and residual biomaterial [ABB: 18,21% (interquartile range from 10,41% to 28,78%) vs. I-BCP: 9,86% (interquartile range 2,18% to 17,06%), P = 0,054 Mann Whitney U test] between groups. However, when comparing the mean percentage of soft tissue in the analyzed biopsies, it was found that the mean percentage of soft tissue was significantly higher in the group in which I-BCP was used than in the ABB biopsy group [ABB: 47,98% (interquartile range of 39,50% to 63,15%) vs. I-BCP: 63,26% (interquartile range 50,06% to 73,30%), P = 0,022, Mann Whitney U test]. Conclusion: This study is the first histological evaluation of I-BCP in human bone biopsies that were harvested six months after socket preservation, and also the first comparison of I-BCP with ABB. Both biomaterials showed good osteoconductivity and biocompatibility with the surrounding tissues. The study demonstrated that the use of I-BCP for alveolar ridge preservation is safe and results in satisfactory bone tissue regeneration. |
