不同骨缺损情况下牙槽嵴保存术对延期种植的影响

摘要

目的：评估不同骨缺损情况下牙槽嵴保存术对延期种植的影响。方法：纳入需拔除下颌单个后牙的患者60例，根据临床和螺旋CT检查将牙槽嵴骨缺损量3～5 mm者纳入A组，＞5 mm者纳入B组。拔牙后再将A、B两大组各随机分为试验组和对照组。试验组牙槽窝使用Bio-Oss骨粉植骨并覆盖Bio-Gide生物膜，对照组牙槽窝不作任何处理，使其自然愈合。术后6个月用牙周探针检查缺牙区邻牙的牙周袋探诊深度（PPD）、牙龈退缩水平（GRL）、临床牙龈附着水平（CAL）各指标，用螺旋CT检测牙槽嵴的骨量变化，植入种植体。术后随访1年，评估种植体稳定性和骨结合情况。结果：术后6个月，A、B两组中试验组和对照组所有患牙邻牙的PPD、GRL、CAL与术前相比均无统计学差异（P＞0．05）。A、B两组中对照组的牙槽嵴骨吸收量均大于相应的试验组（P＜0．05）。种植体植入后3个月内，A组和B组种植体稳定性各组间相比无统计学差异（P＞0．05）；1年内种植体周围骨吸收量各组间相比亦无统计学差异（P＜0．05）。结论：牙槽嵴骨缺损＞5 mm时，牙槽嵴保存术可明显提高牙槽嵴骨量，并为延期种植提供良好的条件。%AIM:To evaluate the alveolar ridge preservation on delayed implantation.METHODS:Before tooth extraction 60 patients were divided into group A (with alveolar ridge defect level of 3~5 mm)and group B (with the defect level of more than 5 mm).After single mandibular molar extraction,the patients in group A and B was di-vided into experimental group(AE and BE)and control group(AC and BC)randomly.In group AE and BE the sockets were filled with Bio-Oss and covered with Bio-Gide membrane,in group AC and BC the sockets were without treat-ment.6 months after tooth extraction periodontal pocket depth (PPD),gingival recession level(GRL),clinical gingi-val attachment level (CAL)were measured clinically,alveolar ridge bone volume was measured with CBCT.Then im-plants were inserted into all sockets and followed up for 1 year.RESULTS:There was no statistical difference in PPD, GRL and CAL changes between AE and AC,and between BE and BC.The alveolar ridge bone resorption in AC and BC was more than that in AE and BE (P<0.05)at 6 month-follow-up.A total of 57 implants were inserted,there was no statistical difference in implant stability between AE and AC,and between BE and BC(P>0.05).There was no statistical difference in the peri-implant bone resorption at 1-year-follow-up.CONCLUSION:The alveolar ridge preservation can preserve the alveolar bone volume when the bone defect is more 5 mm.