美学区种植同期应用异种骨行引导骨再生术后愈合期间唇侧骨改建的临床研究

doi:10.19438/j.cjoms.2017.06.006

中国口腔颌面外科杂志 ›› 2018, Vol. 16 ›› Issue (1): 29-33.doi: 10.19438/j.cjoms.2017.06.006

美学区种植同期应用异种骨行引导骨再生术后愈合期间唇侧骨改建的临床研究

张楚南^#, 倪杰^#, 莫嘉骥, 乔士冲, 王蓓, 顾迎新

上海交通大学医学院附属第九人民医院·口腔医学院口腔种植科,上海市口腔医学重点实验室, 上海市口腔医学研究所,国家口腔疾病临床研究中心,上海 200011

收稿日期:2017-03-09 修回日期:2017-06-01 出版日期:2018-01-20 发布日期:2018-02-11
通讯作者: 顾迎新,E-mail: yingxingu@163.com
作者简介:张楚南（1989-）,女,博士,住院医师, E-mail: zcn1114@163.com;倪杰（1990-）,男,硕士,住院医师,E-mail: nijie1011@hotmail.com。<sup>#</sup>并列第一作者
基金资助:
2015年上海交通大学医工交叉基金（YG2015MS10）

Early regenerated buccal bone remodeling following dental implant surgery with guided bone regeneration in the esthetic area using bone xenografts

ZHANG Chu-nan, NI Jie, MO Jia-ji, QIAO Shi-chong, WANG Bei, GU Ying-xin

Department of Oral Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology. Shanghai 200011, China

Received:2017-03-09 Revised:2017-06-01 Online:2018-01-20 Published:2018-02-11

摘要/Abstract

摘要： 目的: 研究美学区种植同期应用异种骨行引导骨再生（GBR）术后愈合期间的唇侧骨改建。方法: 纳入2015年9月—2016年4月在上海交通大学医学院附属第九人民医院口腔种植科行GBR同期种植体植入的上前牙23例。术前、手术当天及二期手术阶段拍摄锥形束CT（CBCT）,记录牙龈厚度（>2 mm或≤2 mm）、骨质分类及使用的屏障膜。利用iCAT Vision数字化软件对种植体颈部肩台下2 mm（C）、体部中点（M）及根尖处（A）唇侧骨板进行测量,测量线与种植体长轴垂直。将纵切线向近中及远中各移动1 mm,得到新的纵切面,以同样方法测量唇侧骨板厚度并记录数值。在术前CBCT上测量牙槽嵴形态特征,记录牙槽嵴高度、倒凹深度及牙槽嵴宽度。采用SPSS 21.0软件包对数据进行统计学分析。结果: 种植体肩台下2 mm、体部中点及根尖处的平均骨吸收值分别为（0.70±0.59）mm、（0.85±0.72）mm和（0.55±0.51）mm,吸收率分别为23.07%、18.53%和12.97%。与植骨吸收相关的自变量中,相关分析表明,倒凹深度和年龄与植骨吸收量显著相关（P<0.05）;将所有变量纳入多重线性回归并行逐步回归分析,仍具有统计学意义的变量为倒凹深度（P<0.05）。结论: 美学区种植同期应用异种骨行GBR术后愈合期间唇侧会有一定程度的骨吸收。患者年龄及牙槽嵴倒凹对GBR术后愈合期内种植体唇侧骨板的改建具有一定影响。牙槽嵴倒凹越大,GBR术后愈合期内唇侧骨板吸收越少。

关键词: 引导骨再生, 种植牙, 唇侧骨板, 美学区, 锥形束CT

Abstract: PURPOSE: To investigate early regenerated buccal bone remodeling following dental implant surgery with guided bone regeneration (GBR) in the esthetic area using bone xenografts. METHODS: From September 2015 to April 2016, 23 dental implants in the maxillary anterior region with simultaneous GBR using bone xenografts were included in the study. Cone-beam CT (CBCT) was acquired before operation, once the operation was finished and 6 months after surgery. Mucosal thickness (>2 mm or ≤2 mm), types of bone quality and different membranes used were also identified. The buccal bone width perpendicular to implant long axis was taken 2 mm below the implant shoulder, midpoint and apical point of implant body at 3 intervals: the mesio-distal midpoint of the implant and 1mm mesial and distal to the the midpoint. Standardized measurements were taken to record alveolar height, width and undercut depth from preoperative CBCT scans. The data were analyzed using SPSS 21.0 software package. RESULTS: Loss in width of augmented bone after 6 months of healing was (0.70±0.59) mm, (0.85±0.72) mm and (0.55±0.51) mm. Bone absorption rate was 23.07%, 18.53% and 12.97%, respectively. The variables "undercut" and "age" had significant influences on bone graft resorption (P<0.05). Multiple linear stepwise regression analysis revealed that only undercut was the independent risk factor for bone resorption among all variables (P<0.05). CONCLUSIONS: Early regenerated buccal bone remodeling occurs following dental implant surgery with GBR in the esthetic area. Undercut depth and patient age have a significant effect on graft resorption. Consequently, with deeper undercut, decreased resorption could be expected for regenerated buccal bone.

Key words: Guided bone regeneration, Dental implant, Regenerated buccal bone, Esthetic area, CBCT

中图分类号:

R782.1

张楚南, 倪杰, 莫嘉骥, 乔士冲, 王蓓, 顾迎新. 美学区种植同期应用异种骨行引导骨再生术后愈合期间唇侧骨改建的临床研究[J]. 中国口腔颌面外科杂志, 2018, 16(1): 29-33.

ZHANG Chu-nan, NI Jie, MO Jia-ji, QIAO Shi-chong, WANG Bei, GU Ying-xin. Early regenerated buccal bone remodeling following dental implant surgery with guided bone regeneration in the esthetic area using bone xenografts[J]. China J Oral Maxillofac Surg, 2018, 16(1): 29-33.

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美学区种植同期应用异种骨行引导骨再生术后愈合期间唇侧骨改建的临床研究

Early regenerated buccal bone remodeling following dental implant surgery with guided bone regeneration in the esthetic area using bone xenografts

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