后牙牙槽嵴顶保存手术中异种移植材料的应用效果研究

Application of xenotransplantation materials in posterior alveolar ridge preservation surgery

摘要:

目的  分析异种移植材料应用于后牙牙槽嵴顶保存术的临床效果。方法  选取2012年1月-2014年12月该院口腔科治疗拔除后牙并要求种植修复的80例患者为研究对象。将患者随机分为治疗组和对照组，每组40例。治疗组微创拔牙后，于牙槽窝内植入Bio-Oss Collagen骨胶原，并采用Bio-Gide生物膜覆盖于牙槽窝表面；对照组微创拔牙后直接给予缝合，待自然愈合。在拔牙术后即刻及6个月后测量并计算牙槽嵴宽度与高度的变化量、牙间乳突高度变化量及唇舌向宽度变化量。记录两组患者6个月后植入种植体直径及长度。结果  治疗组患者的牙槽嵴高度变化量为（0.37±0.96）mm，大于对照组[（-0.65±1.32）mm]，差异有统计学意义（t =
-3.952，P =0.000）。治疗组患者的牙槽嵴宽度变化量为（-0.84±0.91）mm，低于对照组患者[（-2.13±1.17）mm]，差异有统计学意义（t =-5.504，P =0.000）。治疗组患者的牙间乳突高度变化量为（-0.11±0.23）mm，低于对照组患者[（-1.32±0.76）mm]，差异有统计学意义（t =-10.124，P =0.000）。治疗组患者的唇舌向宽度变化量为（-0.04±0.23）mm，低于对照组患者[（-1.02±0.78）mm]，差异有统计学意义（t =-7.622，P =0.000）。治疗组16（40.0%）例患者种植体直径为4.1 mm，24（60.0%）例患者种植体直径为4.8 mm；对照组27（67.5%）例患者种植体直径为4.1mm，13（32.5%）例患者种植体直径为4.8 mm，经χ2检验，差异有统计学意义（χ2=6.084，P =0.014）。治疗组4（10.0%）例患者种植体长度为8 mm，25（62.5%）例患者种植体长度为10 mm，11（27.5%）例患者种植体长度为12 mm；对照组18（45.0%）例患者种植体长度为8 mm，17（42.5%）例患者种植体长度为10 mm，5（12.5%）例患者种植体长度为12 mm，经χ2检验，差异有统计学意义（χ2=12.683，P =0.002）。结论  Bio-Oss Collagen骨胶原和Bio-Gide可吸收生物膜作为拔牙后牙槽窝的骨代材料能够更好地维持牙槽嵴顶高度及宽度的稳定性，有利于后期牙体种植操作的开展。

Abstract:

Objective To investigate the clinical effect of ridge preservation with xenograft materials in posterior sites. Methods From January 2012 to December 2014, 80 patients with posterior teeth planned to be extracted and replaced by implants in our hospital were enrolled. The patients were randomly divided into treatment group and control group with 40 cases in each group. After minimally-invasive extraction surgery, the treatment group was preserved with Bio-Oss Collagen and Bio-Gide biofilm surface. The socket of the control group was left to heal spontaneously. The alveolar crest width and height, interdental papilla height, and width of buccal to lingua were calculated immediately after the tooth extraction and six months after surgery. And the implant diameter and length were recorded in the two groups. Results The alveolar crest height variation of the patients was (0.37 ± 0.96) mm in the treatment group and (-0.65 ± 1.32) mm in the control group, the difference was statistically significant (t = -3.952, P = 0.000). The alveolar creast width variation was (-0.84 ± 0.91) mm in the treatment group which was significantly lower than (-2.13 ± 1.17) mm in the control group (t = -5.504, P = 0.000). The interdental papilla height variation was (-0.11 ± 0.23) mm in the treatment group and (-1.32 ± 0.76) mm in the control group, the difference was statistically significant (t =
-10.124, P = 0.000). The faciolingual width variation was (-0.04 ± 0.23) mm in the treatment group and (-1.02 ± 0.78) mm in the control group, the difference was statistically significant (t = -7.622, P = 0.000). In the treatment group, 16 patients (40.0%) had the implant diameter of 4.1 mm, and 24 (60.0%) patients had the implant diameter of 4.8 mm; while in the control group, 27 (67.5%) patients had the implant diameter of 4.1 mm, and 13 (32.5%) cases had the implant diameter of 4.8 mm, the differences were statistically significant (χ2 = 6.084, P = 0.014). In the treatment group, 4 patients (10.0%) had implant length of 8 mm, 25 (62.5%) patients had the implant length of 10 mm, 11 (27.5%) patients had the implant length of 12 mm; while in the control group, 18 patients (45.0%) had the implant length of 8 mm, 17 (42.5%) patients had the implant length of 10 mm, 5 (12.5%) patients had the implant length of 12 mm, the differences were statistically significant (χ2 = 12.683, P = 0.002). Conclusions Applying Bio-Oss Collagen and Bio-Gide biofilm to ridge preservation in posterior sites can result in less vertical and horizontal bone resorption of sockets following extraction, which is good for later dental planting operations.