不同方式处理犬下颌磨牙区即刻种植间隙的效果评价  

Effect evaluation on different treatment methods of the gap of immediate implantation in canine posterior mandible

作　　者：张怡雯 邹多宏[1] 张志愿[1] ZHANG Yi-wen;ZOU Duo-hong;ZHANG Zhi-yuan(Department of Oral Surgery,Shanghai Ninth Peoples Hospial,Shanghai Jiao Tong Universily School of Medicine,Clege of Stomaology,Shanghai Jiao Tong University,Na tional Centerfor Stomatology,National Clinical Research Centerfor Oral Diseases,Shanghai Key Laboratory of Stomatology Shanghai 20001l,China)

机构地区：[1]上海交通大学医学院附属第九人民医院口腔外科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海200011

出　　处：《上海口腔医学》2022年第4期337-342,共6页Shanghai Journal of Stomatology

基　　金：国家自然科学基金(31870969);中国医学科学院医学与健康科技创新工程(2019-I2M-5-037);上海交通大学医学院双百人人才计划项目(20191816)

摘　　要：目的:探讨在犬下颌磨牙区即刻种植中,不同方式处理拔牙窝与种植体之间的间隙后的新骨形成情况。方法:选择6条1.5~2.0岁的拉布拉多犬作为实验对象,在每条犬下颌骨中拔除两侧的第四前磨牙和第一磨牙,分别植入4颗牙种植体(Astra Tech■,4.0 mm×10 mm)。种植体和拔牙窝骨壁之间的近远中间隙分别进行3种处理,分为空白组(NN组)、胶质银明胶海绵(Gelatamp)组(EN组)和Gelatamp+可吸收胶原膜(CM)组(EG组)。术后12周收集标本,进行显微CT扫描和组织学分析。采用SPSS 25.0软件包进行统计学分析。结果:牙种植术后12周存活率为100%。显微CT扫描结果显示,新骨高度、骨矿物质密度(BMD)、骨体积分数(BV/TV)、骨表面积骨体积比(BS/TV)、骨小梁厚度(Tb.Th)、骨小梁数(Tb.N)和骨小梁间距(Tb.Sp)等指标,组间无显著差异。组织学分析结果显示,新骨形成面积和种植体与骨接触面积(BIC)在组间无统计学差异。结论:使用不同方式处理种植体与拔牙窝之间的间隙后的12周内,与空白对照组相比,单独放置Gelatamp或与CM联合使用,对种植体周围新骨形成、BIC、BMD、BV/TV、BS/TV、Tb.Th、Tb.N及Tb.Sp等均无显著影响。PURPOSE: This study was aimed to explore the formation of new bone after different methods of filling the gap between the extraction socket and the implant in immediate implantation of the canine mandibular molar area.METHODS: Six Labrador dogs aged 1.5-2.0 years were used as the experimental subjects. The fourth premolar and the first molar were extracted from the mandible of each dog, and then 4 dental implants(Astra Tech■, 4.0 mm × 10 mm) were implanted respectively. The mesial and distal gaps between dental implants and the walls of extraction socket were treated in three methods: blank group(group NN), gelatin sponge with colloidal silver(Gelatamp) group(group EN),Gelatamp + absorbable collagen membrane(CM) group(group EG). At 12 weeks, the dogs were euthanized, and specimens were collected for micro-CT scanning and histological analysis. SPSS 25.0 software package was used for statistical analy-sis. RESULTS: The survival rate at 12 weeks after implantation was 100%. Micro-CT scan results showed no significant differences in new bone height, bone mineral density(BMD), bone volume fraction(BV/TV), bone surface area bone vol-ume ratio(BS/TV), bone trabecular thickness(Tb.Th), bone trabecular number(Tb.N) and bone trabecular separation(Tb.Sp) among different groups. Histological analysis showed no significant differences in the area of new bone formation and bone-implant contact(BIC). CONCLUSIONS: After different treatments are performed on the gap between implants and extraction sockets, Gelatamp alone or in combination with CM has no significant effect on new bone formation, BIC, BMD,BV/TV, BS/TV, Tb.Th, Tb.N and Tb.Sp around implant.

关 键 词：即刻种植 下颌磨牙 拔牙窝 新骨形成面积 犬 

分 类 号：R782.1[医药卫生—口腔医学]