利用Bio-Oss Collagen进行上颌磨牙拔除后拔牙位点保存的临床分析

Clinical analysis of extraction site preservation using Bio-Oss Collagen after extraction of maxillary molars

目的探讨上颌磨牙拔除后,利用Bio-OssCollagen进行拔牙位点保存的临床治疗方法。方法回顾分析采用Bio-OssCollagen进行上颌磨牙拔牙位点保存6名拔牙患者的临床资料。该6例为患牙因牙周炎或牙周牙髓联合病变导致根分叉区域牙槽骨破坏需要拔除,牙拔除后牙槽嵴顶中央剩余骨高度不足3.5mm,但颊舌侧及近远中有接近完整骨壁的病例。拔牙后彻底刮除牙槽窝内肉芽组织,在牙槽窝内植入Bio-OssCollagen,交叉缝合牙龈固定移植物,术后7~10天拆线。分别在术前、术后即刻及术后6个月时拍摄CBCT,使用Mimics20.0测量冠状位颊舌侧及正中、矢状位近远中及正中剩余牙槽嵴顶高度5个位点的垂直高度。结果6名患者拔牙后均一期愈合。拔牙后6个月复查,牙槽窝愈合良好,牙龈颜色质地正常,附着龈宽度无变化。CBCT见测量5个位点中,颊舌侧及近远中位点牙槽嵴顶高度无变化或有少量增高,正中位点牙槽嵴顶高度增加了3.48~7.89mm。结论上颌患牙拔除后,若周围骨壁高度足够,采用Bio-OssCollagen进行拔牙位点保存的方法可行,该方法损伤小、操作时间短,可以取得与传统拔牙位点保存相近的结果。

Objective To investigate a clinical treatment method for extraction site preservation using Bio-Oss Collagen after extraction of maxillary molars.Methods The clinical data of 6 cases were retrospectively analyzed,and all 6 patients were treated with Bio-Oss Collagen for extraction site preservation after extraction of maxillary molar teeth.These six cases met the following characteristics:the affected tooth was destructed in the alveolar bone in the area of its furcation due to periodontitis or combined periodontal-endodontic lesions,and needed to be extracted;the remaining bone height in the top central part of the alveolar ridge was less than 3.5 mm after the extraction of the affected tooth;the bone walls of the buccal,lingual,mesial and distal parts of the extraction socket were nearly intact.After extraction of the affected tooth,the granulation tissue in the alveolar socket was thoroughly removed.Bio-Oss Collagen was placed in the alveolar sockets and the soft tissues were cross-sutured to hold the graft in place.The sutures are removed 7-10 days after surgery.CBCT was taken preoperatively,immediately postoperatively and at six months postoperatively.The vertical height of the remaining alveolar ridge was measured using Mimics 20.0 at five sites:buccal and lingual in the coronal position,mesial and distal in the median sagittal position,and central.Results Primary healing was obtained in all six patients.At 6 months after extraction,the patients had well healed alveolar sockets,normal gingival color and texture,and no change in attached gingival width.CBCT taken at 6 months after extraction showed no change or a small increase in alveolar crest height at the buccal,lingual,mesial and distal sites,but an increase of 3.48 to 7.89 mm at the central site,among the 5 sites measured.Conclusion After extraction of maxillary molars,Bio-Oss Collagen can be used for extraction site preservation if the surrounding bone wall height is adequate.This method causes less trauma,has a shorter operation time,and its results are similar to those of conventional extraction site preservation.