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Een vergelijking van de effectiviteit van verschillende botsubstitutiematerialen ten behoeve van de opvulling van de alveole na extractie als voorbereiding op implantologische behandeling: een systematisch literatuur onderzoek

(2017) Ruler, B. van (Babette)

Purpose: the aim of this systematic review was to compare which bone substitution material has the best effectiveness in increasing the bone or reducing bone resorption after applying in the aveolus immediately after tooth extraction. The purpose of this comparison is to provide an up-to-date overview of the available scientific evidence of the effectiveness of various bone substitution materials for the purpose of alveolar ridge preservation.
Materials and methods: a systematic research is performed to identify and select articles who studied the effectiveness of several bone substitution materials for the purpose of alveolar ridge preservation. The data was compared with the aid of a descriptive analysis, which subdivided the data by measuring method and mean follow-up.
Results: of the 351 identified articles, 18 were included in this systematic review. In the included articles, different bone substitution materials were compared to other bone substitution materials or to control groups where no bone substitution materials were used. The comparison of clinical data revealed that Bio-Oss® has the best effectiveness after 12 weeks to 3 months, that Bio-Oss® + BPAM, CaS + DFDBA and Bio-Oss® + BioGide® have the best effectiveness after 16 weeks to 4 months and that NanoBone® + BioGide® and Bio-Oss® + BioGide® have the best effectiveness after 6 to 7 months. The comparison of radiographic data revealed that Bio-Oss® has the best effectiveness in increasing the radiographic bone density after 12 to 14 weeks and that MGCSH + ConFORM® and CRP + ConFORM® have the best effectiveness in reducing the loss of vertical bone thickness after 3 months. The comparison of histological/histomorphometric data revealed that CRP + ConFORM® have the best effectiveness in increasing the mean percentage of new/vital bone after 12 weeks to 3 months, that MEHA has the best effectiveness in increasing the mean percentage new/vital bone after 16 weeks to 4 months and that NHA + CS and BHA + CS have the best effectiveness in increasing the mean percentage of new/vital bone after 5 to 7 months.
Conclusion: the choice of bone substitution material that has the best effectiveness for alveolar ridge preservation depends on the measuring method and on the time of measuring. It can be concluded that the best time to place dental implants is 4 months after extraction and ridge preservation using Bio-Oss® + BPAM if the aim is the preservation of de clinical horizontal bone thickness. If preservation of the vertical bone thickness is the aim, the best time to place dental implants is 19 weeks after tooth extraction and alveolar ridge preservation with 70% FDBA + 30% DFDBA with d-PTFE membrane.





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