浓缩生长因子联合脱蛋白牛骨基质位点保存效果的临床及组织学评价  

Clinical and histological evaluations of the effects of concentrated growth factor combined with deproteinated bovine bone mineral in site preservation

作　　者：李枭 王连飞 程刚 LI Xiao;WANG Lianfei;CHENG Gang(School of Stomatology,Bengbu Medical University,Bengbu 233030,China;Department of Stomatology,The First People's Hospital of Linan District,Hangzhou 310014,China;Department of Stomatology,Zhejiang Provincial People's Hospital,Hangzhou 310014,China)

机构地区：[1]蚌埠医学院口腔医学院,安徽蚌埠233030 [2]临安区第一人民医院口腔科,浙江杭州310014 [3]浙江省人民医院口腔科,浙江杭州310014

出　　处：《口腔疾病防治》2022年第6期412-418,共7页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：浙江省自然科学基金项目(LGF18H140006);浙江省医药卫生科技项目(2022KY505)。

摘　　要：目的 从临床及组织形态计量学角度评价浓缩生长因子(concentrated growth factor,CGF)联合脱蛋白牛骨基质(deproteinated bovine bone mineral,DBBM)在拔牙位点保存中成骨效果。方法 选取需拔除患牙并接受位点保存后延期种植的26例患者为研究对象,采用随机数字表法将患者分为DBBM组和CGF+DBBM组,每组13例。DBBM组拔牙后同期植入DBBM,CGF+DBBM组拔牙后同期植入CGF+DBBM,两组均覆盖BioGide胶原膜。术前、术后6个月分别拍摄CBCT以测量牙槽骨高度、宽度的变化,并于位点保存术后6个月种植术中钻取骨标本进行组织学观察和组织形态计量学分析。结果 影像学结果显示CGF+DBBM组和DBBM组位点保存术后6个月牙槽骨高度和宽度均发生吸收,CGF+DBBM组牙槽嵴宽度吸收少于DBBM组,且差异具有统计学意义(P <0.05);组织形态计量学结果显示CGF+DBBM组和DBBM组新生骨平均面积百分比分别为(35.30±3.56)%、(26.38±5.04)%,CGF+DBBM组新生骨量优于DBBM组,且差异具有统计学意义(P <0.05)。结论 CGF联合骨替代材料DBBM可以更有效地维持拔牙后牙槽骨体积、形态,其成骨效果优于DBBM单一材料的应用,可为种植修复创造有利条件。Objective To evaluate the osteogenic effect of concentrated growth factor(CGF) combined with deproteinated bovine bone mineral(DBBM) in site preservation using clinical and histomorphometric observations. Methods A total of 26 patients who needed extraction of affected teeth and received staged implantation after site preservation were selected. The patients were randomly divided into the DBBM group(Bio-Oss was implanted simultaneously after extraction) and CGF+DBBM group(CGF+Bio-Oss was implanted simultaneously after extraction), with 13 patients in each group, and both groups were covered with Bio-Gide collagen membrane. Cone beam computed tomography(CBCT)was performed preoperatively and 6 months later to measure the changes in alveolar bone height and width, and the bone specimens were drilled 6 months after site preservation during implant surgery for histological analyses. Results CBCT showed that the height and width of alveolar bone were absorbed 6 months after site preservation in the CGF+DBBM and DBBM groups, and the reduction in alveolar ridge width in the CGF+DBBM group was statistically less than the DBBM group(P < 0.05). The histomorphometry results showed that the percentage of new bone in the CGF+DBBM and DBBM groups were 35.30% ± 3.56% and 26.38% ± 5.04%, respectively, and the amount of new bone in the CGF+DBBM group was statistically higher than the DBBM group(P < 0.05). Conclusion CGF combined with DBBM is superior to DBBM in maintaining the alveolar bone volume and shape in site preservation, which creates favorable conditions for implant restoration.

关 键 词：牙种植 位点保存 骨替代材料 脱蛋白牛骨基质 BIO-OSS Bio-Gide胶原膜 引导骨再生 浓缩生长因子 新生骨 组织形态计量学 

分 类 号：R78[医药卫生—口腔医学]