152例胶原生物膜联合羟基磷灰石生物陶瓷治疗牙周和根尖骨缺损的临床疗效分析

Efficiency of oral biofilm and hydroxyapatite on periodontal and periapical bone defects:report of 152 cases

目的分析应用海奥胶原生物膜联合羟基磷灰石生物陶瓷人工骨治疗152例牙周及根尖骨缺损患者的临床疗效。方法临床收集2006年6月至2010年9月重庆医科大学附属口腔医院牙周科牙周骨缺损和或并有根尖骨缺损患者152例,完善根管治疗,常规牙周龈上洁治、龈下刮治、根面平整后,行翻瓣术植入羟基磷灰石生物陶瓷人工骨填充骨缺损,置海奥胶原生物膜,每隔6个月复查,X线片观察植入后的牙周牙槽骨和根尖骨缺损区骨组织愈合情况,检查探诊出血、牙周袋探诊深度、附着丧失、松动度和牙槽骨情况,并进行比较和统计分析。结果经过1～4年的追踪观察,有效138例,总有效率90.8%,无效14例,占9.2%。术后牙周骨缺损患者中牙周袋深度(periodontal probing,PD)较基线(5.80±0.86)mm明显变浅[术后6个月PD值(3.33±0.64)mm,P<0.05];术后附着丧失(clinical attachment loss,CAL)较之基线(6.10±0.83)mm变化明显[术后6个月CAL值为(3.52±0.32)mm,P<0.05]。结论海奥胶原生物膜联合羟基磷灰石生物陶瓷作为骨组织支架材料能广泛应用于口腔科骨修复和骨替代等治疗,临床疗效可靠。

Objective To determine the clinical effectiveness of Heal-all oral biofilm and hydroxyapatite bioactive glass ceramic in the treatment of periodontal bone defects and periapical bone defects among 152 patients.Methods A total of 152 patients with periodontal and periapical bone defects were selected as subjects from our hospital from June 2006 to September 2010.After completed root canal therapy,conventional supragingival scaling,subgingival scaling and root planning,they were treated by surgical treatments including flap surgery implanting hydroxyapatite bioactive glass ceramics and oral biofilm in the bone defect area.All the patients were examined at 3 and 6 months,and 1,2,3 and 4 years by X-rays to observe the concrescence of alveolar bone and apical bone defects after treatment.Bleeding on probing（BOP）,probing depth（PD）,clinical attachment lose（CAL）,movement（M） and alveolar bone level were inspected.The therapeutic results were analyzed with SPSS15.0 soft package for Chi square test.Results Of the 152 cases,138 were cured during the follow-up period of 1 to 4 years,with the cure rate of 90.8%,and 14 cases failed to the treatment with the failure rate of 9.2%.The value of PD was changed from the baseline of（5.80±0.86） mm to（3.33±0.64） mm in 6 months after the treatment（P0.05）.The value of CAL was obviously changed from the baseline of（6.10±0.83） mm to（3.52±0.32） mm in 6 months after the treatment（P0.05）.Conclusion As materials of bone tissue bracket,Heal-all oral biofilm and hydroxyapatite（HAP） can be wildly used in the areas of bone restoration and bone substitute.It is effective in the clinical treatment and will be widely used in the bone engineering.