种植床自体骨复合珊瑚羟基磷灰石在牙种植手术中的临床应用研究

Clinical application of coralline hydroxyapatite combined with autogenous bone taken from implantation bed in dental implant

目的评价种植床自体骨复合珊瑚羟基磷灰石在牙种植手术中的临床应用效果。方法 32例(37颗)种植牙病例分成A、B两组。A组24例(27颗种植体),植入德国Ankylos螺纹种植体后,在部分暴露的植体处植入珊瑚羟基磷灰石。B组8例(10颗种植体),采用经牙槽嵴顶入路,使用德国费亚丹公司的FRIOS^R空心取骨钻进行定位定向和定深度后制备圆柱状骨,游离取出后即刻碾磨成碎骨颗粒,与珊瑚羟基磷灰石混合后植入到种植体周骨缺损区。植入术后4～6个月暴露种植体,最终完成烤瓷冠修复,二期手术时根据成骨情况评估成骨效果。结果两组病例均获得了良好的骨修复效果,单纯珊瑚羟基磷灰石植骨后成骨效果满意及基本满意率共为85.19%。自体骨与珊瑚羟基磷灰石混合植骨后的成骨效果满意及基本满意率共为100.00%。结论种植床自体骨可作为有效的植骨材料,手术创伤小,无需开辟第2手术区,值得推广。

Objective To evaluate the clinical outcome of coralline hydroxyapatite combined with autogeneous bone taken from implantation bed in dental implant. Methods 32 patients （37 implants） were divided into two groups. Group A： Coralline hydroxyapatite was the only graft in the bone defect area in 27 implants （24 patients）, covered with resorbable collagen membrane or titanium membrane; Group B： FRIOSR Trephine was used for the preparation of autogenenous bone pieces. Coralline hydroxyapatite and autogenous bone particles were mixed and placed in the bone defect area in 10 implants （8 patients）, covered with barrier membrane. Ridge dimensions around the implants were clinically or radiographicaUy measured in stage I or Ⅱ operation. Results New bone formation was observed at stage Ⅱ operation performed at 4- 6 months after stage I in both groups. Most of the patients showed satisfactory bone regeneration effects. The satisfactory rate of bone regeneration effects in group A and group B was 85.19% and 100% separately. Conclusion Using bone graft harvested from implantation bed could achieve an effective clinical outcome. It is minimally invasive operation and deserves popularization.