三种用于牙周骨下袋缺损再生性手术的骨移植骨粉临床效果研究  

Comparison of clinical effects of three kinds of bone graft in the treatment of periodontal intra-bony defects

作　　者：康健[1] 赵静[1] 李晶 张颖[1] 苏瑞 马勇强 王志涛[1] 李新月[1] Kang Jian;Zhao Jing;Li Jing;Zhang Ying;Su Rui;Ma Yongqiang;Wang Zhitao;Li Xinyue(Department of Periodontology,Tianjin Stomatological Hospital,Tianjin 300041,China)

机构地区：[1]天津市口腔医院牙周科,300041

出　　处：《国际生物医学工程杂志》2019年第6期503-507,共5页International Journal of Biomedical Engineering

基　　金：天津市卫生计生委科技基金重点攻关项目(16KG149)。

摘　　要：目的比较拜欧金、骨立方和Bio-Oss 3种骨移植材料联合引导组织再生术(GTR)治疗牙周骨下袋缺损的临床效果。方法选取18例具有骨下袋缺损的慢性牙周炎患者,随机分为拜欧金组、骨立方组和Bio-Oss组。所有患者在牙周基础治疗后行牙周植骨术联合GTR手术。于术前、拆线(术后2周)、术后6个月时采集患者临床和影像学资料,包括牙周探诊深度(PD)、临床附着丧失(CAL)、牙龈退缩(GR)和剩余牙槽骨高度(RBH)。结果所有患者在拆线时,伤口均愈合良好,达到I期愈合,无感染及伤口裂开现象,术后不适感均可接受。牙周植骨联合GTR术后6个月,3组的PD和CAL指标较术前均有显著改善(均P<0.05),且3组间PD和CAL的差异无统计学意义(均P>0.05)。影像学检查结果表明,术后6个月,3组均可见原骨缺损区有新骨形成,骨密度与周围骨组织近似,RBH%均较术前显著增加(均P<0.05),且3组间RBH%的差异无统计学意义(均P>0.05)。结论拜欧金、骨立方和Bio-Oss均为可靠的牙周炎所致牙槽骨缺损治疗骨移植材料,均能显著改善成骨效果。Objective To compare the clinical effects of guided tissue regeneration(GTR)combined with different bone graft materials,including Bio-Gene,Bone3 and Bio-Oss,in the treatment of periodontal intra-bony defects.Methods Eighteen patients with chronic periodontitis with periodontal intra-bony defects were randomly divided into the Bio-Gene group,the Bone3 group and Bio-Oss group.After periodontal debridement,periodontal bone grafting combined with GTR surgery was performed in all patients.The clinical and radiographic parameters of patients were collected before surgery,suture removal(2 weeks after surgery),and 6 months after surgery,including periodontal exploration depth(PD),clinical attachment loss(CAL),gingival recession(GR),and residual alveolar bone height(RBH).Results The wounds healed well in all patients when the suture was removed.The stage I healing was obtained without infection or wound dehiscence,and the postoperative discomfort was acceptable.At 6 months after periodontal bone grafting combined with GTR treatment,the PD and CAL indexes in the three groups were significantly improved compared with those before surgery(all P<0.05),and there was no significant difference in PD and CAL between the three groups(all P>0.05).Imaging results showed that new bone formation was observed in the original bone defect area in all three groups after 6 months of the treatment,the bone density was similar to the surrounding bone tissue.Besides,the RBH%increased significantly compared with that before the treatment(all P<0.05),and there was no significant difference in RBH%among the three groups(all P>0.05).Conclusions Bio-Gene,Bone3 and Bio-Oss are all reliable bone graft materials for the treatment of alveolar bone defects caused by periodontitis,which can significantly improve the osteogenesis effect.

关 键 词：牙周炎 骨下袋 牙周植骨术 引导组织再生术 骨粉 

分 类 号：R78[医药卫生—口腔医学]