应用Bio-Oss胶原与异体脱细胞真皮基质保存拔牙创硬组织的临床研究  

Clinical study of tissue preservation of extraction socket with Bio-Oss collagen and acellular dermal matrix

作　　者：胡秀莲[1] 林野[1] 王健[1] 吴茴[1] 邱立新[1] 张宇[1] 

机构地区：[1]北京大学口腔医学院口腔医院口腔种植中心,北京100081

出　　处：《中华口腔医学杂志》2009年第9期513-516,共4页Chinese Journal of Stomatology

摘　　要：目的拔牙后即刻在牙槽窝内植人Bio-Oss胶原并用异体脱细胞真皮基质（acellular dermal matrix，ADM）关闭拔牙创，观察拔牙创内软硬组织的组织学特点及临床效果。方法2005年11月至2006年6月接受种植治疗的连续11例患者，共14个牙位（设为植骨组），拔除患牙同期植入Bio-Oss胶原，ADM关闭拔牙创，3-5个月后植入种植体并完成永久修复。临床检查拔牙创愈合情况并观察组织学愈合特点。同时设自然愈合对照组10例（10个牙位），观察其拔牙创自然愈合3个月后的牙槽嵴宽度和附着龈宽度变化，并行统计学分析。结果植骨组拔牙创愈合良好，拔牙创牙槽嵴丰满、软组织形态与邻牙协调，所有种植体均完成永久修复，末次复查未见种植体脱落，平均追踪时间为27.9个月（24-31个月）。统计学分析结果显示，植骨组牙槽嵴宽度植骨前（7.69±0.48）mm，植骨后（7.68±0.48）mm，附着龈宽度植骨前（4.36±1.02）mm，植骨后（4.32±0.98）mm，经比较，差异无统计学意义（P〉0.05）；自然愈合对照组与植骨组间的差值比较，差异有统计学意义（P〈0.05）。组织学观察见新生骨组织长入植骨区，未见炎症细胞浸润及纤维组织长入。结论本组应用Bio-Oss胶原和ADM保存拔牙创软硬组织，近期临床效果可靠。Objective To evaluate the clinical and histological results of extraction socket preservation using Bio-Oss collagen and aeellular dermal matrix （ADM）. Methods From November 2005 to June 2006, a total of 11 cases underwent extraction socket preservation with Bio-Oss collagen and ADM in 14 extraction sites. Ten eases with 10 teeth undergoing extraction without bone graft served as control group. Clinical and histological examinations were conducted. Pre-and postoperative alveolar ridge width and attached gingival width were measured and statistically analyzed. Results All the grafted sockets healed uneventfully except one. Thirteen implants were placed 3-5 months after extraction. After 4 to 6 months permanent restorations were delivered. The mean follow-up time was 27.9 months （24 to 31 months）. In the control group the sockets healed uneventfully, while hard and soft tissue collapsed obviously 3 months after extraction. No significant difference was found in the width of alveolar ridge and attached gingiva before and after extraction in the bone graft group （ P 〉 0. 05 ）. The width of alveolar ridge before （7.69±0.48）mm and after extraction（7.68±0.48） nun and in the width of attached gingiva before（4.36±1.02） mm and after extraction （4.32±0.98） mm in the bone graft group （P 〉 0. 05 ）. Histological examination showed adequate new bone formation around Bio-Oss particles 3 months after operation. The specimen was free of inflammatory cells. Conclusions It＇s effective to preserve the extraction sockets with Bio-Oss collagen and ADM and the short-term results were predictable.

关 键 词：拔牙 牙种植 牙槽突 

分 类 号：R686[医药卫生—骨科学]