珊瑚羟基磷灰石骨块移植在重度牙槽骨缺损中的应用效果评价  

Evaluation of the effect of coral hydroxyapatite bone block grafting in severe alveolar bone defects

作　　者：周琛 王文雪 贾仁杰[3] 李欣[1] 梅东梅 李亚男[1,2] 赵保东[1,2] ZZHOU Chen;WANG Wen-xue;JIA Ren-jie;LI Xin;MEI Dong-mei;LI Ya-nan;ZHAO Bao-dong(Department of Oral Implantology,Afiliated Hospital of Qingdao University.Qingdao 266003;School of Stomatology,Qingdao University,Qingdao 266003;Department of Stomatology,Affiliated Qingdao Central Hospital of Qingdao University.Qingdao 266042,Shandong Province,China)

机构地区：[1]青岛大学附属医院口腔种植科,山东青岛266003 [2]青岛大学口腔医学院,山东青岛266003 [3]青岛大学附属青岛市中心医院口腔科,山东青岛266042

出　　处：《中国口腔颌面外科杂志》2023年第3期231-236,共6页China Journal of Oral and Maxillofacial Surgery

基　　金：青岛市医药卫生科研计划项目(2021-WJZD183);青岛大学附属医院临床医学+X科研项目(QDFY+X2021004)。

摘　　要：目的:评价应用珊瑚羟基磷灰石骨块治疗重度牙槽骨缺损的安全性和有效性。方法:选择2019年1月—2021年1月青岛大学附属医院口腔种植科就诊且种植区牙槽骨量严重不足的患者29例,其中13例进行珊瑚羟基磷灰石骨块移植(CHA骨块组),16例进行自体骨块移植(自体骨块组)。术前(T0)、术后即刻(T1)、术后6个月(T2)、种植体植入后即刻(T3)行CBCT检查,以种植体长轴为中心,测量距离牙槽嵴顶0 mm(L1)、3 mm(L2)、6 mm(L3)的骨宽度,比较2组骨增量、骨吸收量等。记录患者植骨术后疼痛程度,创口裂开、感染、骨块坏死等并发症发生情况。采用SPSS 26.0软件包对数据进行统计学分析。结果:所有患者均成功完成植骨手术,成功植入种植体并完成最终修复,平均随访(13.28±4.34)个月。植骨术后6个月,CHA骨块组的骨增加量高于自体骨块组,CHA骨块组的骨吸收量低于自体骨块组,但差异均无统计学意义(P>0.05);CHA骨块组疼痛反应显著低于自体骨块组(P<0.05)。结论:水平向牙槽骨重度缺损患者应用珊瑚羟基磷灰石骨块进行骨增量,可以获得种植所需骨量,安全有效,无需开辟第二术区,疼痛反应轻,易于被患者接受,值得临床推广应用。PURPOSE:To evaluate the safety and efficacy of coral hydroxyapatite bone blocks in the treatment of severe alveolar bone defects.METHODS:Twenty-nine patients with severe alveolar bone defect were recruited from Jan 2019 to Jan 2021 in the Affiliated Hospital of Qingdao University.Thirteen patients underwent coral hydroxyapatite bone blocks grafing(CHA bone block group),16 patients underwent autogenous bone blocks grafting(autogenous bone block group).To compare the bone augmentation and resorption between the two groups,CBCT was taken before(TO),immediately after(T1),6 months after augmentation surgery(T2)and immediately after implant surgery(T3).The bone width of 0 mm(L1),3 mm(L2),and 6 mm(L3)from the top of the alveolar ridge was measured.The pain intensity,complications(soft tissue dehiscence,infection or bone necrosis)after bone grafting were recorded.SPSS 26.0 software package was used for statistical analysis.RESULTS:All 29 patients were implanted successfully after bone grafting and finished restorations.The average fllow-up was(13.28±4.34)months.There was no significant difference in bone augmentation and bone absorption 6 months after operation between the two groups(P>0.05).The pain response of CHA bone block group was significantly different from that of autologous bone block group(P<0.05).CONCLUSIONS:Coral hydroxyapatite bone block could be used for bone augmentation for severe horizontal bone defects,which could obtain bone mass required for implantation.There is no second operation area,less pain response,safe and effective.This technique might be accepted easily for patients,and is worthy of wide clinical application.

关 键 词：珊瑚羟基磷灰石 自体骨移植 骨增量 骨缺损 

分 类 号：R782.1[医药卫生—口腔医学]