自体牙本质作为骨移植材料的临床应用进展  

Clinical application of autogenous dentin as a bone graft material

作　　者：肖闻澜 胡琛 荣圣安 屈依丽[2] XIAO Wenlan;HU Chen;RONG Sheng′an;QU Yili(State Key Laboratory of Oral Diseases&National Clinical Research Center for Oral Diseases&West Chi⁃na Hospital of Stomatology,Sichuan University,Chengdu 610041,China;Department of Implantology,West China Hospital of Stomatology,State Key Laboratory of Oral Diseases,National Clinical Research Center for Oral Diseases,Si⁃chuan University,Chengdu 610041,China)

机构地区：[1]口腔疾病研究国家重点实验室,国家口腔疾病临床医学研究中心,四川大学华西口腔医院,四川成都610041 [2]口腔疾病研究国家重点实验室,国家口腔疾病临床医学研究中心,四川大学华西口腔医院种植科,四川成都610041

出　　处：《口腔疾病防治》2020年第6期394-398,共5页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：国家重点研发计划(No.2016YFC1102705/2016YFC1102700)。

摘　　要：自体牙本质是一种很有前景的生物材料,可作为自体骨的替代物,目前已用于拔牙后位点保存术、上颌窦底提升术和牙槽嵴骨增量术。而其临床运用方式非常多样,尚无统一的标准或规范。本文综述自体牙本质的临床应用,为进一步优化其性能、拓展其运用提供新的思路。文献复习结果表明,移植前,自体牙本质材料将经过一定加工,其中脱矿为目前最常见的化学改性方式。脱矿可以增强自体牙本质的骨传导与骨诱导性能,但复杂耗时的操作过程在一定程度上限制了它的应用,部分脱矿或许是更合适的选择;移植时,自体牙本质的形态与骨缺损形态以及手术方式有关,直径不等的颗粒材料便于填充不规则缺损,块状材料利于重建部位的空间维持,镂空框架状材料加工方式稍复杂,但可以结合颗粒与块状移植物的优势。除了单独应用外,自体牙本质还可以与多种生物材料联合移植。富血小板血浆配合自体牙本质材料,已在临床研究中展现出理想效果。硫酸钙石膏、磷酸钙陶瓷也曾在动物实验中联合人牙本质材料,但由于尚未应用于人体,其临床效果还需要进一步研究论证。Autogenous dentin is a promising biological material that can be used as a substitute for autologous bone.It has been used in postextraction site preservation,maxillary sinus floor elevation,and alveolar ridge augmentation.The clinical application methods of autologous dentin have showed great diversity without uniform standard.The present arti⁃cle reviewed the clinical application of autogenous dentin to provide new ideas for its future development.The literature review results show that dentin materials require several preparations before transplantation,among which the deminer⁃alization is a common chemical processing method.Demineralization can enhance the osteoconductive and osteoinduc⁃tive properties of dentin,but the complex and time⁃consuming operation process has limited its application to a certain extent.Partial demineralization may be a more appropriate choice.During transplantation,the morphology of dentin de⁃pends on the condition of the bone defect and the surgical method.Granular materials with different diameters are con⁃venient for filling irregular defects.Block materials are conducive to maintaining the space of the reconstruction site.Hollow frame materials are slightly more complicated to process but can combine the advantages of granular and block grafts.In addition to being used alone,dentin can also be transplanted in combination with multiple biological materi⁃als.Platelet⁃rich plasma combined with dentin materials has shown ideal results in clinical studies.Plaster of paris and calcium phosphate ceramics have also been combined with dentin materials in animal experiments.But since they have not been applied in humans,their clinical effects require further research.

关 键 词：自体牙本质 脱矿 骨替代材料 骨诱导 骨传导 骨再生 骨增量 口腔种植 

分 类 号：R78[医药卫生—口腔医学]