应用羟基磷灰石生物陶瓷引导骨再生对单牙种植修复体牙龈形态的影响  

The effect of guided bone regeneration with coralline hydroxyapatite on gingival morphology of single implant prostheses

作　　者：胡晓文[1] 李斯日古愣[1] 李玲蔚[1] 李翠君[1] 

机构地区：[1]中山大学光华口腔医学院.附属口腔医院.口腔医学研究所,广州510055

出　　处：《中华口腔医学研究杂志（电子版）》2010年第2期48-54,共7页Chinese Journal of Stomatological Research(Electronic Edition)

摘　　要：目的探讨伴有不同程度骨缺损的单牙缺失区引导的再生骨对种植修复体周围牙龈形态美学的影响。方法对53例单牙缺失伴有不同程度牙槽骨缺损的患者进行标准牙种植手术,同期应用羟基磷灰石生物陶瓷行骨引导再生术(GBR),观察引导再生骨的形成情况。在修复即刻、修复后3、6个月时,对种植体顶骨缘吸收和种植修复体周围牙龈形态、龈缘水平、牙龈质地、龈乳头结构和龈缘出血状况的变化进行评价。结果引导的再生骨充满骨缺损,骨质良好。在修复后6个月,4例出现种植体顶边缘骨吸收超过1个螺纹,与骨缺损类型无关。随功能负重时间延长,种植修复体牙龈美学效果改善明显,但牙龈形态和龈乳头结构不完整在骨缺损较大病例中的发生率明显高于小型骨缺损病例。结论羟基磷灰石生物陶瓷具有良好的引导骨再生作用,充足的引导再生骨是维持种植修复体周围牙龈正常形态结构的决定性因素。Objective To study the effect of guided regenerative bone on the esthetic outcomes of peri-implant gingival tissue in the site of single tooth-loss with various extent of alveolar defect. Methods 53 patients with single missing tooth and presenting various extent of alveolar defect were treated with standard implant surgery protocol. The guided bone regeneration procedures were performed with coralline hydroxyapatite simultaneously. The situation of bone healing and guided bone regeneration were observed. Marginal bone level around the implant shoulder, the morphology, marginal level, quality, papilla architecture, as well as the marginal bleeding of the gingiva tissue surrounding the implant prostheses were evaluated immediately after implant restoration and at 3- and 6-month follow-up respectively. Results The guided regenerative bone grew well and covered the defects completely. At 6- month follow-up, implant marginal bone resorption of over 1 screw was found in 4 patients, not relevant with the defect type. The gingival esthetic outcomes was improved significantly with the increase of functional loading-time; but the incidence of unmatched gingival shape and papilla architecture in the patients with larger alveolar defect is higher than the patients with smaller defect. Conclutions Coralline hydroxiapatite is well able to guide new bone to regenerate. Sufficient guided regenerative bone is a decisive factor for maintaining the natural gingival shape and structure around the implant.

关 键 词：羟基磷灰石生物陶瓷 骨缺损 骨引导再生术 牙龈形态 

分 类 号：R783[医药卫生—口腔医学]