非手术干预对引导骨再生术后患者屏障膜早期暴露的预后影响

The influnce of non-surgical interventions on prognostic of barrier membranes early exposure after guided bone regeneration

目的研究非手术干预对引导骨再生术(GBR)后伤口裂开、屏障膜过早暴露于口腔环境的转归及预后的影响。方法选择2009年1月～2012年12月江苏扬州友好医院口腔科及安徽医科大学口腔医学院附属口腔医院因牙槽骨量不足行GBR治疗的81例患者作为研究对象,根据术后伤口情况将其分A组(43例)、B组(22例)、C组(16例),给予A、B两组非手术干预治疗。观察各组GBR治疗后2周内伤口裂开、非手术干预期间和Ⅱ期手术时软组织愈合情况及手术部位影像学边缘骨吸收(MBL)情况。结果 81例患者中,术后2周内伤口裂开发生率高达53.09%,通过非手术干预治疗,A组患者暴露的膜均被牙龈组织重新覆盖,Ⅱ期手术时,12例有MBL,B组11例有MBL,C组仅2例有MBL。三组间MBL发生率差异有统计学意义(P<0.05);A组种植体近、远中MBL吸收量[(0.48±0.19)、(0.52±0.24)mm]均高于B组[(1.00±0.39)、(0.80±0.40)mm],差异均有统计学意义(均P<0.05)。结论及时进行非手术干预可使GBR治疗后伤口裂开者获得有效的延期愈合。

Objective To study the outcomes and prognostic impact of non-surgical interventions on prognostic of wound dehiscence and barrier membranes early exposure after guided bone regeneration（GBR）. Methods 81 patients with GBR treatment because of inadequate alveolar bone mass from January 2009 to December 2012 in Stomatology Department of the Friendliness Hospital of Yangzhou and Stomatology Hospital Afflilated to Anhui Medical University School of Stomatology were selected as study objected,they were divided into group A（43 cases）,group B（22 cases）,group C（16 cases） according to the condition of postoperative wounds,both the group A and group B were given the non-surgical interventions. The wound healing in 2 weeks after GBR,the wound dehiscence,non-surgical intervention and soft tissue healing during Ⅱ period surgery of and Imaging edge of bone resorption of operative site were observed. Results The total rate of wound dehiscence in 81 patients was as high as 53.09% in 2 weeks after surgery. Within group A,there was marginal bone loss（MBL） in 12 patients,11 patients in group B,and only 2 patients of group C,occurrence rate of MBL in 3 groups had statistically significant difference（P〈 0.05）. Both the mean mesial and distal marginal bone of group A [（0.48±0.19）,（0.52±0.24） mm] were higher than those of group B [（1.00±0.39）,（0.80±0.40） mm],the differences were statistically significant（all P 〈0.05）. Conclusion The timely non-surgical intervention to early barrier membrane exposure after GBR is an effective strategy to obtain delayed soft tissue healing.