可吸收生物膜在牙种植中的临床应用

Clinical observation of bioabsorbable membrane used in dental implantation

目的:观察可吸收生物膜在牙种植术中的应用及其组织学反应。方法:在本院门诊2008年6月至2009年1月行牙种植术同时使用可吸收生物膜(海奥口腔修复膜)的46例患者中,男性30例,女性16例。其中,种植区GBR26例,骨劈开11例,上颌窦开窗提升8例,上颌窦黏膜穿孔修补1例。术后使用抗生素3～5天。种植术后1w、2w、4w、4m观察种植区愈合情况,术后4m行X片检查。在术后4m对3例患者I期手术时覆盖生物膜处的黏膜进行活检取材,固定后HE染色观察组织学愈合情况。结果:46例患者在术后复查中,未出现过敏症状,未见种植区脓性分泌物和生物膜脱落。术后4w时种植区黏膜无肿胀,颜色与周围黏膜一致。术后4m时X片未见种植体周围透射影。种植II期手术时种植体稳固无动度,未见残留生物膜。上颌窦开窗和窦底黏膜穿孔修补患者均未见上颌窦异常表现。组织学切片显示,黏膜上皮层结构完整,结缔组织层偶见淋巴细胞,未见生物膜残留物和纤维包膜。结论:可吸收生物膜可成功用于牙种植骨增量和上颌窦开窗提升术。

Objective:To evaluate the clinical outcome and histological exhibition of the bioabsorbable membrane used in dental implantation.Methods:46 patients(16 females and 30 males)received the dental implantation in this study and the bioabsorble membranes(Heal Mouth Rehabilitation Membrane)were used in these patients.26 patients were treated with guided bone regeneration(GBR),11 patients were treated with bone splitting combined with GBR,8 patients were treated with lateral elevation of maxillary sinus floor,and one patient for maxillary sinus perforation repair.Clinical parameters of the peri-implant conditions were assessed at 1w,2w,4w.Both clinical and radiographic parameters were assessed at 4 months.The mucosa of 3 patients were taken and evaluated after HE(hematoxylin-eosin)staining.Results:There was no hypersusceptibility,purulent secretion and bioabsorbable membrane detachment in all patients.No signs of mucosa swell and color abnormality were observed at 4 weeks.No implants mobility and X-ray radiolucency were observed at 4 months after the stage-one surgery.There was no abnormity of the sinus for the patients of sinus floor augmentation.Histological appearance showed that the mucosa was intact,and the casual infiltration of lympholeukocyte in some area of connective tissue,but there was no residual membrane or fibrous capsule.Conclusion:The bioabsorbable membrane can be successfully used for the alveolar augmentation of dental implantation and maxillary sinus floor elevation.