前牙拔牙位点保存术后牙槽嵴软硬组织变化的临床研究  

Clinical research on changes of soft and hard tissue after the preservation in the front tooth extraction sites

作　　者：承峥 孙秋望月[1,2] 葛昕 王晨星[1,2] 李怀奇[1,2] 叶金海[1,2] 李中连[1,2,4] CHENG Zheng;SUN Qiuwangyue;GE Xin;WANG Chenxing;LI Huaiqi;YE Jinhai;LI Zhonglian(Jiangsu Key Laboratory of Oral Disease,Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学口腔疾病研究江苏省重点实验室,江苏南京210029 [2]南京医科大学附属口腔医院口腔颌面外科,江苏南京210029 [3]东南大学医学院江阴市人民医院口腔科,江苏江阴214400 [4]东南大学附属中大医院无锡分院无锡市锡山人民医院口腔科,江苏无锡214105

出　　处：《口腔医学》2019年第1期20-24,共5页Stomatology

基　　金：国家自然科学基金(81371123);"科教强卫工程"医学重点人才项目;江苏高校优势学科建设工程资助项目(2018-87)

摘　　要：目的采用锥形束CT(cone beam computed tomography,CBCT)和模型间接测量法评价前牙拔牙同期位点保存6个月后牙槽嵴骨量及软组织量的变化。方法纳入29例患者共32颗符合拔牙适应证的前牙,试验组牙拔除术后应用去骨蛋白牛骨基质(deproteinizedboving bone mineral,DBBM,Bio-Oss)和可吸收生物膜(海奥)进行拔牙位点保存术,对照组行常规拔牙术后未予特殊处理。全部患者拔牙术前取石膏模型,术后即刻及术后6个月拍摄CBCT并于术后6个月再次取石膏模型,通过CBCT和模型测量对比分析术后6个月牙槽骨及软组织高度和宽度的变化。结果通过对比手术前后的CBCT测量结果,牙槽骨高度在唇侧和腭侧牙槽骨的高度测量结果差异有统计学意义(P<0.05)。术后6个月试验组唇侧和腭侧牙槽骨高度显著高于对照组(P<0.05),分别为(16.31±0.94) mm和(18.61±1.10) mm,牙槽骨宽度在根长的20%、70%测量值也显著高于对照组(P<0.05),分别为(4.43±0.32) mm和(4.79±0.37) mm,但在根长50%处两种方法测量结果差异无统计学意义(P>0.05)。软组织高度在上颌牙龈缘最高点及下颌牙龈缘最低点处,试验组((9.26±0.40) mm)显著高于对照组(P<0.05),但在近中龈乳头、远中龈乳头处软组织两组间无显著统计学差异(P>0.05)。结论前牙拔牙同期进行位点保存术处理,对拔牙后牙槽嵴高度、宽度和牙龈软组织的保存均具有积极意义,值得临床实践中推广。Objective To evaluate the changes of alveolar bone and soft tissue after 6 months of the front tooth extraction site preservation by cone beam computed tomography(CBCT)and model measurement. Method A total of 32 teeth from 29 patients with indications for the front tooth extraction were enrolled. Deproteinizedbovine bone mineral(DBBM,Bio-Oss)and absorbable biofilm(Hao)were used in the experimental group when the extraction site was performed,while the control group received no special treatment after routine extraction. The gypsum model was employed before the operation(baseline)and after six months,while the CBCT was taken immediately after the operation(baseline)and six months later as well. The changes of the height and width of alveolar bone and soft tissue were compared and analyzed by CBCT and model measurement. Results Before and after the surgery,there were statistically significant differences in the heights of the labial and palatal alveolar bone assessed by CBCT(P<0.05).After 6 months,the heights of labial and palatal alveolar bone of the experimental group were significantly higher than those of the control group(P< 0.05),which were(16.31±0.94)mm and(18.61±1.10)mm respectively. The alveolar bone widths,measured at 20% and 70% of the root length,were also significantly higher than the control group(P<0.05),which were(4.43± 0.32)mm and(4.79± 0.37)mm respectively,but there was no significant difference between the two groups at 50% of the root length(P>0.05). The heights of soft tissue were significantly higher in the treatment group((9.26 ± 0.40)mm)than the control group(P<0.05)at the highest point of the maxillary gingival margin and the lowest point of the mandibular gingival margin,but in soft tissue between mesial papilla and distal nipple,there was no statistically significant difference(P>0.05). Conclusions The simultaneous preservation of extraction sites of the front teeth has positive significance for the preservation of height,width and alveolar soft tissue after tooth extraction,which is

关 键 词：拔牙位点保存 牙槽嵴高度及宽度 软组织高度 

分 类 号：R782.11[医药卫生—口腔医学]