引导骨再生术在上颌前牙骨缺损中的的临床应用研究

Clinical application of GBR in bone defect of anterior maxilla

目的应用锥束CT(CBCT)评价引导骨再生术(GBR)在上颌前牙骨缺损病例位点保存术后的临床效果。方法对28颗上前牙拔除后存在骨缺损的病例分别给予不同处理:其中A组9例拔牙窝及骨缺损处填充Bio-oss;B组9例填充Bio-oss,骨缺损处置Bio-Guide生物膜;C组10例自然愈合。术后6～8周、20～22周2次复诊,摄CBCT测量缺牙处唇舌向牙槽嵴宽度,行不同组间及组内的前后比较。结果各组牙槽嵴宽度前后测量存在差异(P<0.05);A组与B组间差异不明显(P>0.05),A、B组与C组间前后差值存在显著差异(P<0.05)。结论 GBR术促进颊舌向骨组织再生,有利于骨缺损的恢复。通过位点保存技术能为拔牙后存在明显骨缺损的病例后期种植提供良好的种植条件;CBCT能为临床提供精确的术前术后诊断依据。

Objective Using cone beam CT to evaluate the effects of guided-bone-regeneration（GBR） in the bone defect of anterior maxilla after site-preservation.Methods 28 maxillary anterior teeth with bone defect after extraction were randomly selected to receive different treatments.9 cases in group A were filled with Bio-oss at teeth extraction socket.9 cases in group B were filled with Bio-oss and Bio-Guide was put in the bone defect.10 cases in group C healed naturally.Alveolar ridge widths in labial-lingual direction at teeth loss place were measured by CBCT in the follow-ups during 6~8 week period and 20~22 week period after treatment.Intra-group comparison and intergroup comparison were performed on changes of preoperative and postoperative measurements.Results The differences in changes of ridge widths before and after operation were statistically significant in each group（P0.05）.Difference between group A and group B was not significant（P0.05）.There was significant difference in changes of ridge widths before and after treatment between group A,B and C（P0.05）.Conclusions GBR can improve the bone tissue generation in buccolingual direction and restoration of bone defect.It can provide good condition of the teeth with obvious bone defect after tooth extraction for later implantation by site-preservation.CBCT is able to provide basis for accurate clinical pre-operative and postoperative diagnosis.