β-磷酸三钙复合自体骨移植修复种植牙骨缺损的临床应用

The clinical application of β-TCP combined with autologous bone from implant bed to restore bone deficiency in tooth implantation

目的应用β-磷酸三钙(β-TCP)人工骨复合自体骨移植于种植术中骨缺损部位,解决种植术区骨量不足的问题。方法对58例骨量不足患者植入102颗ITI种植体,同期于骨缺损部位植入自体骨与β-磷酸三钙人工骨复合物,表面覆盖可吸收胶原膜。术后6个月、1年、2年、3年通过临床检查和X线曲面断层片、数字化牙片,评价种植体承载后周围骨的稳定性。结果植入骨缺损区的102颗种植体,1颗种植体术后1月唇侧出现瘘管,6个月后种植体松动脱落;3颗种植体承载8个月后出现唇侧骨吸收,2年后种植体松动拔出。其余种植体经过6～36个月术后承载随访观察,种植体稳定,新生骨未见明显骨吸收。结论β-磷酸三钙人工骨复合自体骨移植修复种植体周围骨缺损,新生骨与种植体能达到骨结合,成骨效果好,新生骨稳定。

Objective This study was to afford a remedy for bone deficiency in dental implantation,by transplanting β-TCP combined with autologous bone from implant bed into the surgical area with bone defects.Methods We implanted 102 ITI implants into the surgical area in 58 cases with the problem of bone defficiency,as well asβ-TCP-autologous bone complex,with the surfaces covered by absorbable collagenic membranes.The steadiness of peripheral bone after implants beared loads was evaluated through panoramic radiographs,digital preiapical peripheral films and clinial examinations 6 months,1 year,2 years,3 years after-surgery.Results One implant developed labial fistula 1 month after surgery and loosened 6 months later,and finally fell off.Three implants had labial bone resorption after they started bearing loads and had to be pulled out after 2 years of loading because of looseness.The remaining 98 implants were stable and the new bone had no noticeable bore resorption according to the follow-up observations 6~36 months after implants beared loads.Conclusions When transplanting β-TCP combined with autologous bone from implant bed to restore bone defects surrounding the implants,bone combination can be achieved between new bone and implants and the new bone is stable,so that the ossification is favorable.