羟基磷灰石复合骨诱导蛋白“夹心”式植入牙槽嵴加高术

Mandibular ridge augmentation by sandwich osteotomy and BMP HA implantation

为解决粘膜裂开、溃疡形成及术后变形等问题，采用羟基磷灰石（ｈｙｄｒｏｘｙａｐａｔｉｔｅ，ＨＡ）复合骨诱导蛋白（ｂｏｎｅｍｏｒｐｈｏｇｅｎｉｃｐｒｏｔｅｉｎ，ＢＭＰ）“夹心”式植入修复牙槽嵴萎缩。动物实验术后行光镜和扫描电镜观察，临床病例术前术后进行Ｘ光片检查。结果显示：实验动物术后植入物牢固，周围有大量新骨形成且多面与宿主骨连接。由于牙槽嵴顶部外形、解剖结构完好，临床检查见修复效果可靠，并发症较少，术后义齿修复满意。结果表明：采用ＨＡ－ＢＭＰ复合物“夹心”式植入修复牙槽嵴萎缩有如下优点：①利用ＨＡ与ＢＭＰ共同作用，生物相容性好，具备骨引导和骨诱导双重功能，新骨形成快而多；②植入物与原牙槽嵴多面结触，诱导新骨形成作用强，植入物固位好，术后牙槽嵴不易变形，增加高度大、可靠；③保持了牙槽嵴顶的原解剖结构，不易形成粘膜破裂及溃疡；④形成的新骨与原宿主骨为直接连结，强度大；⑤手术简捷、安全。

In order to solve a series of problems ridge augmentation by subperiosteal implantstion,HA combined with BMP was implanted in between the two pieces of mandible produced by osteotomy.Nine adult mongrel dogs were used in this study and six patients were treated with this mathod.The specimens were examined by light microscope,scanning electron microscope in the experimental study. The results show that there are a large amount of new bone formation both within and around the combined material.The amount is increasing as the time lapsed and the new bone is connected directly with the host bone of two side. Clinical application showed that after augmentation of the atrophic alveolar ridge with this mathod,the shape and volume of the alveolar ridge were good.The retention and stability of the lower denture was improved significantly. The results showed that this method of alveolar ridge augmentation has many advantages.