异种成型胶原骨引导种植体周围骨缺损再生的临床研究  

Clinical study on allogeneic molded collagen bone to guide the regeneration of peri-implant bone defects

作　　者：李佳芙 吕红 周静 刘情 蒲奕名 卜鸿鹄 刘清辉 曲彬彬 LI Jiafu;LYU Hong;ZHOU Jing;LIU Qing;PU Yiming;BU Honghu;LIU Qinghui;QU Binbin(School of Dental Medicine,Hunan University of Traditional Chinese Medicine,Changsha 410208,China)

机构地区：[1]湖南中医药大学口腔医学院,湖南长沙410208 [2]长沙市口腔医院种植修复科,湖南长沙410005

出　　处：《口腔医学》2023年第4期322-326,共5页Stomatology

基　　金：湖南省自然科学基金项目(2018JJ6130);长沙市科技计划项目(kh005015)。

摘　　要：目的 前瞻性评价软块状含10%胶原的去蛋白无机牛骨(DBBM-C)与颗粒状去蛋白无机牛骨(DBBM)引导种植体周围骨缺损再生的骨体积变化和稳定性差异。方法 通过牙槽骨缺损与预期种植体植入位点的关系将缺损分为Ⅰ-0的拟种植位点(18个)进行种植一期手术,种植体放置后颊侧出现5~8 mm“V”型骨开裂,同期行引导性骨再生术(GBR),试验组(DBBM-C组)10个,采用DBBM-C+胶原膜(CM),对照组(DBBM组)8个,采用DBBM+CM。术后即刻、术后6个月和术后12个月,CBCT分析测量种植体唇颊侧颈部水平骨厚度(d)、45°骨厚度(d45)和骨高度(h)。结果 两组术后即刻d、d45和h数值不同,差异无统计学意义;术后6个月和12个月DBBM-C组d和d45数值均高于DBBM组,差异有统计学意义(P<0.05),h值组间差异无统计学意义;术后即刻-术后6个月d和d45变化值,DBBM-C组低于DBBM组,差异有统计学意义(P<0.05),h变化值组间差异无统计学意义;术后6个月-术后12个月d、d45和h变化值,两组差异无统计学意义。结论 在本研究中,DBBM-C+CM在引导种植体周围骨缺损再生的骨体积变化小于DBBM+CM,DBBM-C+CM在引导种植体周围骨缺损再生的稳定性优于DBBM+CM。Objective To conduct prospective evaluation of bone volume changes and stability differences between regeneration of peri-implant bone defects guided by soft block-shaped deproteinized inorganic bovine bone containing 10%collagen(DBBM-C)and granular deproteinized inorganic bovine bone(DBBM).Methods Implant surgery was performed on the proposed implant sites(18),which were classified as I-O by the relationship between the alveolar bone defect and the expected implant placement site.“v”shaped bone dehiscence 5-8 mm occurred on the buccal side after implant placement,and guided bone regeneration(GBR)was done simulta-neously,with 10 DBBM-C+collagen membrane(CM)and 8 DBBM+CM.Immediately after surgery,six months after surgery and twelve months after surgery,CBCT was performed and analyzed to measure the horizontal bone thickness(d),45°bone thickness(das)and bone height(h)of the labial and buccal side of the implant at cervical level.Results Values of d,d4s and h immediately after surgery were different between the two groups,and the differences were not statistically significant;values of d and dys in the DBBM-C group were higher than those in the DBBM group at 6 and 12 months postoperatively(P<0.05),and the differences were statistically significant.Differences between groups in h values were not statistically significant.Values of d and das changes from the immediate postoperative period to 6 months after surgery were lower in the DBBM-C group,and the differences were statistically significant.The difference in changes of h values between the two groups was not statistically significant;the difference between the two groups was not statistically significant in d,d4s and h change values from 6 months to 12 months after surgery.Conclusion In this study,DBBM-C+CM showed less bone volume change than DBBM+CM in guiding the regeneration of peri-implant bone defects and had better stability.

关 键 词：骨替代材料 引导性骨再生(GBR) 骨体积变化 稳定性差异 

分 类 号：R782.1[医药卫生—口腔医学]