去蛋白牛骨基质与可吸收胶原膜的磨牙拔牙位点保存效果影像学评价

摘要/Abstract

摘要： 目的：与自然愈合比较，观察存在骨缺损的磨牙拔牙同期植入去蛋白牛骨基质（Bio-Oss^®）并覆盖可吸收胶原膜（Bio-Gide^®）愈合6个月后牙槽骨高度和宽度的变化。方法：16名患者共18颗因牙周病变拔除的磨牙纳入本研究，分为对照组（牙齿拔除后自然愈合组）和试验组（应用去蛋白牛骨基质与可吸收胶原膜拔牙位点保存组）。术后即刻及术后6个月拍摄平行投照根尖片和锥束计算机体层摄影术（cone-beam computed tomography, CBCT）检查，通过根尖片和CBCT测量评价术后6个月牙槽骨高度和宽度的变化。结果：术后6个月试验组中央和远中颊侧的牙槽骨高度分别增加2.90 mm和1.45 mm，而对照组中央和远中颊侧的牙槽骨高度分别降低1.00 mm和1.45 mm，两组间差异有统计学意义（P＜0.05），但两组骨宽度变化的差异无统计学意义（P＞0.05）。结论：存在骨缺损的磨牙应用去蛋白牛骨基质与可吸收胶原膜进行拔牙位点保存，可明显增加颊侧牙槽骨高度和牙槽嵴顶根方1 mm和4 mm处牙槽骨宽度。

关键词: 拔牙, 间隙保持, 牙槽骨质丢失, 生物相容性材料, 磨牙

Abstract: Objective: To compare the bone dimensional changes following tooth extraction alone with extraction plus ridge preservation (using deproteinized boving bone mineral Bio-Oss^®and bioresorbable collagen mambrane Bio-Gide^®) in periodontal compromised extraction sockets. Methods: Eighteen molars of sixteen subjects requiring tooth extraction because of periodontal destruction were enrolled in this study. The subjects were assigned to the control group (extraction alone, EXT) or to the test group (ridge-preservation procedure with Bio-Oss^®and Bio-Gide^®, RP). Parallel periapical X-rays and cone-beam computed tomography (CBCT) scans were taken immediately after tooth extraction alone or plus ridge-preservation (baseline) and 6 months later. The changes of horizontal ridge width and vertical ridge height were assessed. Results: At the central buccal aspect, the ridge height increased 2.9 mm in RP group, and reduced 1.0 mm in EXT group. At the distal buccal aspect, the ridge height increased 1.45 mm in RP group, and reduced 1.45 mm in EXT group. The differences between the groups reached statistical significance (P<0.05). The mean ridge width increased at the 1 mm below the crest (the horizontal ridge width was measured with grafting material at three levels at 1 mm below the most coronal aspect of the crest, HW1), which amounted to 3.40 to 5.80 mm in RP group, and 1.45 to 2.90 mm in EXT group. The mean ridge increased at the 4 mm below the crest (the horizontal ridge width was measured with grafting material at three levels at 4 mm below the most coronal aspect of the crest，HW4), which amounted to 0.40 to 3.50 mm in RP group, and reduced 0.10 to increased 0.15 mm in EXT group. The test group and the control group were not significantly different (P>0.05).Conclusion: The ridgepreservation approach using Bio-Oss^®in combination with Bio-Gide^®can significantly increase vertical ridge height and horizontal ridge width after tooth extraction compared with extraction alone in periodontal compromised molars.

Key words: Tooth extraction, Space maintenance, Alveolar bone loss, Biocompatible materials, Molar

詹雅琳, 胡文杰, 甄敏, 徐涛, 路瑞芳. 去蛋白牛骨基质与可吸收胶原膜的磨牙拔牙位点保存效果影像学评价[J]. 北京大学学报（医学版）, 2015, 47(1): 19-26.

ZHAN Ya-Lin, HU Wen-Jie, ZHEN Min, Xu-Tao, Lu-Rui-Fang. Radiographic evaluation of ridge preservation after molar tooth extraction: a controlled clinical trial[J]. Journal of Peking University(Health Sciences), 2015, 47(1): 19-26.

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