种植体固定的钛网复合脱钙牙基质增高牙槽嵴的研究  

STUDY ON ALVEOLAR RIDGE AUGMENT THROUGH TECHNIQUE COMBINATION OF IMPLANT-RETENTED TITANIUM LATTICE WITH DECALCIFIED DENTAL MATRIX IMPLANTING

作　　者：谢迎[1] 刘斌[1] 岑远坤[2] 李志革[1] 董跟喜[1] 

机构地区：[1]兰州大学口腔医学院 [2]四川大学华西口腔医学院

出　　处：《中国修复重建外科杂志》2008年第4期476-480,共5页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：甘肃省自然科学基金资助项目(3ZS041-A25-054)~~

摘　　要：目的观察种植体固定钛网同时植入脱钙牙基质(decalcified dental matrix,DDM)修复增高犬上颌牙槽嵴的可行性。方法取1～2岁龄健康雄性杂交家犬6只,体重10～20kg。拔除双侧上颌前磨牙,于2周后行改良延迟即刻种植手术。随机选取一侧为实验组,于第1、3磨牙将种植体植入固定钛网,将DDM植入钛网下;另一侧为对照组,不植入DDM。术后4、9及14周分别处死2只犬,行大体观察,摄X线片测量术后14周实际增高的牙槽嵴高度,并于各时间点行组织学观察及组织学定量观察。结果术后实验犬存活良好。实验组术后4、9周X线片观察示骨密度明显高于对照组,14周钛网下和种植体周骨密度与周围无明显区别;对照组骨密度低,发生骨吸收。14周钛网升高高度,实验组为(1.93±0.24)mm,对照组为(-1.02±1.20)mm,差异有统计学意义(P<0.05)。组织学观察示术后4周,实验组DDM表面部分吸收,对照组种植体颈部周围有炎性纤维组织存在;9周,实验组有部分新骨形成,对照组炎性纤维组织向种植体根部及钛网下发展;14周,实验组DDM已基本吸收,形成成熟的骨小梁及骨皮质,种植体为骨性结合,对照组无新骨形成,为纤维组织充填。定量组织学研究显示,实验组种植体在新骨段和非新骨段的骨接触率之比约为1∶1,差异无统计学意义(P>0.05)。结论种植体固定的钛网复合DDM增高牙槽嵴术是治疗萎缩牙槽嵴的一种可行方法。Objective To evaluate the effect of technique combination of implant-retented titanium lattice with decalcified dental matrix （DDM） implanting. Methods Six healthy male dogs （weighing of 10-20 kg） were randomly divided into 3 groups. All the premolars were extracted on both sides of the jaw in dogs. After 2 weeks, titanium lattice and implant were implanted in the maxillary premolar region with DDM on one side （experimental group）, but without on the other side （control group） of each dog. After 4, 9 and 14 weeks, respectively, 2 animals were individually killed each time, and the samples were evaluated by general observation, X-ray examination, histological observation and histomorphometric analyses. Results General observation： Among the 6 dogs, there was no postoperative infection or death. The X-ray examination showed that the bone density of the experimental group was greater than the control group at 4 and 9 weeks, and had no significant difference as to the vicinity bone at 14 weeks. On the other hand, the density of the control group was very low under the titanium lattice and around the implant. The experimental group revealed a ridge augment of （1.93± 0.24） mm, and control group （-1.02 ± 1.20） mm （P 〈 0.05）. Developed bone sponge could be found after 14 weeks. Histological observation showed that in the experimental group, the DDM surface was nearly absorbed at 4 weeks. A few new bones were formed at 9 weeks. The whole DDM was absorbed; the trabecular bone was thick and arranged regularly; and the intergradations of implant were observed at 14 weeks. In the control group, there were some inflammatory fibers around the neck of implant at 4 weeks. The inflammatory condition extended to the root of implant and the titanium lattice at 9 weeks. There was no newly-formed bone under the titanium lattice at 14 weeks. Histomorphometric analyses showed that the implant contact boneratio approached 1 ： 1, and showed no significant difference between the new bone fragment and for

关 键 词：种植体 脱钙牙基质 牙槽嵴增高术 犬 

分 类 号：R783[医药卫生—口腔医学] R318[医药卫生—临床医学]