自体骨植骨修复第二磨牙远中骨缺损的疗效研究  

Effect of Autogenous Bone Grafting on Distal Bone Defect of Second Molar

作　　者：王韵杰 骆德平[1] WANG Yun-jie;LUO De-ping(Department of Maxillofacial Surgery,Oral Branch of Chongqing Three Gorges Central Hospital,Chongqing 404100,China)

机构地区：[1]重庆三峡中心医院口腔分院颌面外科

出　　处：《中国美容医学》2019年第10期126-130,共5页Chinese Journal of Aesthetic Medicine

摘　　要：目的:观察自体骨植骨修复第二磨牙远中骨缺损的临床疗效。方法:纳入2015年10月-2017年10月笔者医院收治的因拔除下颌阻生第三磨牙致第二磨牙远中骨缺损的80例患者为研究对象。按抽签随机方法分为两组。观察组:40例,拔牙后行自体骨植骨;对照组:40例,拔牙后不植骨。观察两组手术前后第二磨牙远颊角骨缺损深度(ODD)、探诊深度(PD)及临床附着水平(CAL),对比两组手术时间、开口度、肿胀度、不良反应发生情况及术后新生骨量、形态,并使用视觉模拟评分法(VAS)及术后症状严重度评估量表(PoSSe),评估两组术后疼痛及术后症状严重度。结果:观察组术后7d及术后6、12个月ODD均显著低于术前及对照组(P<0.05),术后6、12个月CAL均显著低于对照组(P<0.05)。观察组手术时间、肿胀度显著高于对照组(P<0.05),开口度显著小于对照组(P<0.05)。观察组PD、VAS评分、PoSSe评分及不良反应发生率与对照组比较,差异无统计学意义(P>0.05)。术后6个月,CBCT显示观察组可见不规则自体骨,新骨密度不均匀;对照组见自缺损底部伴新骨生成,骨密度较为均匀。术后12个月,CBCT显示观察组不规则自体骨较前显著减少,缺损区顶部伴骨白线形成,骨密度较前相对均匀;对照组可见新骨生成明显,骨小梁细弱。结论:与不植骨比较,自体骨植骨对第二磨牙远中骨缺损的修复作用明显,安全性较好。Objective In order to observe the clinical effect of autogenous bone graft in repairing distal bone defect of second molar.Methods 80 patients with distal bone defect of the second molar caused by the extraction of impacted mandibular third molars admitted to our hospital from October 2015 to October 2017 were included as research objects.According to the random method of drawing lots,the patients were divided into two groups,40 cases in each group.The observation group received autogenous bone grafting after tooth extraction,while the control group received no bone grafting after tooth extraction.The depth of defect(ODD),the depth of exploration(PD)and the level of clinical attachment(CAL)of the distal buccal horn of the second molars were observed before and after operation.The operation time,degree of opening,degree of swelling,occurrence of adverse reactions,bone mass and morphology were compared between the two groups.Visual analogue scale(VAS)and Postoperative Symptom Severity Assessment Scale(PoSSe)were used to evaluate the postoperative pain and severity of symptoms in the two groups.Results ODD in the observation group was significantly lower than that in the preoperative and control groups 7 days after operation and 6 and 12 months after operation(P<0.05),and CAL in the 6 and 12 months after operation was signi ficantly lower than that in the control group(P<0.05).The operation time and swelling degree of the observation group were signi ficantly higher than those of the control group(P<0.05),and the opening degree was significantly lower than that of the control group(P<0.05).There was no signi ficant difference in PD,VAS score,PoSSe score and incidence of adverse reactions between the observation group and the control group(P>0.05).At 6 months after operation,CBCT showed irregular autologous bone and uneven new bone density in the observation group;In the control group,new bone formation was seen at the bottom of the defect,and the bone density was more uniform.At 12 months after operation,CBCT showed

关 键 词：自体骨植骨 下颌第二磨牙 远中骨缺损 探诊深度 临床附着水平 

分 类 号：R782.12[医药卫生—口腔医学]