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拔牙后牙槽嵴保存的初步临床研究(1)
http://www.100md.com 2018年1月15日 《医学信息》 2018年第2期
     摘 要:目的 观察拔牙后牙槽窝即刻植入Bio-Oss Collagen 对于早期牙槽嵴形态的影响。方法 选取8例需要对称减数下颌第一恒前磨牙(共16个牙位)的正畸病例,微创拔除后,两侧采取不同处理方式将其分为两组。实验组8个牙位,拔牙窝即刻植入Bio-Oss Collagen,“8”字缝合拔牙窝两侧软组织;对照组8个牙位,拔牙窝自然愈合。拔牙后10 d观察拔牙窝愈合情况,12 周复诊取模型,采用牙槽嵴地图法测量拔牙位点牙槽嵴水平宽度,与拔牙前比较。结果 所有病例拔牙窝均正常愈合,拔牙后12周,在测量位点,两组病例牙槽嵴水平宽度均较前减少,实验组差值小于对照组,两者之间的差异有统计学意义(P<0.05)。结论 Bio-Oss Collagen的植入减轻了拔牙后牙槽嵴的萎缩,较好地保存了拔牙位点的水平骨量。

    关键词:拔牙窝;牙槽嵴保存;Bio-Oss Collagen

    中图分类号:R783 文献标识码:A DOI:10.3969/j.issn.1006-1959.2018.02.004
, 百拇医药
    文章编号:1006-1959(2018)02-0009-02

    Abstract:Objective To observe the effect of Bio-Oss Collagen immediately after tooth extraction on the morphology of early alveolar ridge.Methods 8 orthodontic cases with symmetrical normotensive mandibular first permanent premolars(total 16 teeth)were selected.After minimally invasive surgery,they were divided into two groups according to different treatments.In the experimental group of 8 teeth,the tooth socket was immediately implanted with Bio-Oss Collagen,and the "8" suture was used to suture the soft tissues on both sides of the tooth socket.In the control group,8 teeth were cured.At 10 d after tooth extraction, the healing condition of the extraction socket was observed.At the 12-week follow-up,the model was taken and the alveolar crest width of the extraction site was measured by alveolar ridge mapping method.Results Tooth extraction in all cases were normal healing,12 weeks after tooth extraction,in the measurement sites,the two groups of patients with alveolar ridge width decreased compared with the former,the experimental group difference is smaller than the control group,the difference was statistically significant(P<0.05). Conclusion The implantation of Bio-Oss Collagen reduced the atrophy of the alveolar ridge after tooth extraction,and better preserved the horizontal bone mass at the tooth extraction site.
, 百拇医药
    Key words:Tooth extraction;Alveolar ridge preservation;Bio-Oss Collagen

    牙拔除術后缺失区牙槽嵴会发生生理性改建,在6个月内牙槽嵴宽度可减少29%~63%,高度降低11%~22%,且牙槽嵴吸收颊侧较舌侧更显著[1-3]。萎缩改建,由于骨量的减少,给后期牙列的修复尤其是种植修复带来困难。本文遵循牙槽嵴保存的理念,微创拔牙后即刻植入Bio-Oss Collagen,评价其牙槽嵴保存的早期效果,现分析如下。

    1资料与方法

    1.1一般资料 选取2014年6月~2016年12月在武汉科技大学附属汉阳医院口腔科就诊的8例患者,年龄13~17岁,平均年龄(15.01±0.36)岁。本研究经汉阳医院医学伦理委员会批准。告知治疗计划,患者同意并签署知情同意书。纳入标准:需对称拔除下颌第一前磨牙(包括同时需拔除上颌前磨牙)进行正畸治疗;减数牙无龋坏、根尖周炎;拔牙后下颌12周安装正畸矫治器。8例患者,共16个牙位,微创拔除后,一侧拔牙窝即刻植入Bio-Oss Collagen,列入实验组(8个牙位),另一侧自然愈合,列入对照组(8个牙位)。

    1.2材料 Bio-Oss Collagen(Geistlich Pharma AG,Switzerland)。

    1.3方法 患者术前30 min口服抗菌素,局麻下微创拔牙,实验组牙槽窝即刻植入Bio-Oss Collagen,高度与邻牙牙槽嵴高度平齐或稍高,3/0可吸收线“8”字交叉无张力缝合;对照组常规压迫止血,自然愈合。, 百拇医药(陈冶)
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