保留反应性软组织联合脱矿牙本质基质应用于拔牙位点保存  

Reactive soft tissue preservation combined with demineralized dentin matrix for extraction site preservation

作　　者：戴婕婷 任碧晖 徐业豪 郭水根[1] 魏洪武 Dai Jieting;Ren Bihui;Xu Yehao;Guo Shuigen;Wei Hongwu(Affiliated Rehabilitation Hospital of Nanchang University,Nanchang 330000,Jiangxi Province,China)

机构地区：[1]南昌大学附属康复医院,江西省南昌市330000

出　　处：《中国组织工程研究》2025年第17期3557-3565,共9页Chinese Journal of Tissue Engineering Research

摘　　要：背景:反应性软组织内的干细胞间充质具有促进组织再生的潜力,脱矿牙本质基质具有良好的生物相容性,可以作为位点保存术的支架材料,促进骨细胞的附着、增殖和分化。目的:影像学分析拔牙保留反应性软组织1个月后、行脱矿牙本质基质位点保存术后6个月牙槽骨高度和宽度的变化。方法:纳入38例患者共62个拔牙位点,拔除患牙保留反应性软组织1个月后应用脱矿牙本质基质行位点保存术,术前、术后即刻、术后6个月拍摄锥形束CT,分别测量近中骨高度、中央骨高度、远中骨高度、颊侧骨高度、舌侧骨高度、牙槽嵴宽度,根据拔牙后剩余牙槽窝骨壁数量分为一壁骨缺损、二壁骨缺损、三壁骨缺损、四壁骨缺损。比较位点保存术前、术后即刻、术后6个月的骨量变化。结果与结论:①在骨愈合期间无位点发生创口感染;②与位点保存术前比较,术后即刻骨高度、骨宽度明显增加(P<0.05);术后6个月骨高度增加(P<0.05),骨宽度无明显变化(P>0.05);与术后即刻比较,术后6个月骨宽度吸收了(1.253±2.896)mm(P<0.05),骨高度无明显变化(P>0.05);③位点保存术后即刻、术后6个月4种骨缺损类型的骨高度明显增加(P<0.05),骨宽度无显著变化(P>0.05);术后6个月较术前一壁骨缺损近中骨量增长最少(P<0.05),二壁骨缺损近中骨量增长最多(P<0.05);④结果表明:脱矿牙本质基质应用于位点保存术可有效预防和减缓拔牙术后的牙槽骨吸收,能够在一定程度上重建已发生吸收的牙槽骨轮廓;拔牙术后保留反应性组织应用于脱矿牙本质基质位点保存术中,可实现创口封闭,临床疗效好;脱矿牙本质基质应用于一壁、二壁、三壁、四壁牙槽窝位点保存效果相似,但总体而言,脱矿牙本质基质应用于骨壁完整的拔牙窝时位点保存效果更为优良。BACKGROUND:Stem cell mesenchyme within reactive soft tissues has the potential to promote tissue regeneration.Demineralized dentin matrix,which has good biocompatibility,can be used as a scaffold material for the site preservation surgery to promote the attachment,proliferation,and differentiation of osteoblasts.OBJECTIVE:To evaluate the changes in alveolar bone height and width after 6 months of site preservation with demineralized dentin matrix after 1 month of extraction of affected teeth with preservation of reactive soft tissues.METHODS:A total of 38 patients with 62 extraction sites were included.One month after the extraction of the affected teeth with preservation of reactive soft tissues,demineralized dentin matrix was used to perform site-preservation surgery.Cone-beam CT was taken preoperatively,immediately postoperatively,and 6 months postoperatively to measure the proximal-medial bone height,central bone height,distal-medial bone height,buccal bone height,lingual bone height,and alveolar bone height,and alveolar bone width.Extraction defects were categorized as one-,two-,three-,or four-wall defects based on the number of alveolar fossa bone walls remaining after tooth extraction.Changes in bone volume were compared preoperatively,immediately postoperatively,and 6 months postoperatively.RESULTS AND CONCLUSION:No wound infection occurred at any site during bone healing.Compared with preoperative data,there was a significant increase in alveolar bone height and bone immediately postoperatively(P<0.05);there was also an increase in alveolar bone height but no change in alveolar bone width 6 months postoperatively(P>0.05).Compared with the immediate postoperative period,alveolar bone width was increased by(1.253±2.896)mm 6 months postoperatively,but there was no change in alveolar bone height(P>0.05).The bone height of the four bone defect types was significantly increased immediately and 6 months postoperatively(P<0.05),and no changes in the bone width were observed(P>0.05).Compared with the preoperativ

关 键 词：影像学研究 位点保存 脱矿牙本质基质 反应性软组织 骨壁缺损 

分 类 号：R496[医药卫生—康复医学] R318[医药卫生—临床医学] R783.1