海奥口腔修复膜复合骨填充材料在低位阻生第三磨牙自体牙移植术中的应用

The application of Heal-all biological membrance combined bone filling material on repair of bone defect when autotransplanting low site impacted mandiblular third molar to the second molar

目的:采用海奥口腔修复膜复合骨填充材料修复低位阻生第三磨牙自体移植至第二磨牙后的骨缺损.方法:对各种原因造成的下颌第二磨牙病变无法保留且远中牙槽骨吸收,邻牙为低位近中或水平阻生第三磨牙的常规治疗为拔除两颗牙齿,后期种植义齿或活动义齿修复.若实施自体牙移植术,即拔除第二和第三磨牙,然后将第三磨牙移植入第二磨牙牙槽窝,但因为颊侧及远中骨缺损多,植入后牙齿不易固定且活动性大,以往并不是自体牙移植术的适应证.本研究针对上述问题在拔牙同期将适量人工骨粉(Bio-oss或天然煅烧骨修复材料,陕西瑞盛生物科技有限公司,骼瑞)填入移植牙颊侧和远中骨缺损区,并采用海奥口腔修复膜(烟台正海生物技术有限公司),经形态修剪后覆盖于骨粉表面.缝合黏膜组织后用金属麻花丝弹性固定移植牙.覆盖牙周敷料保护创面.结果:移植牙术后固定良好,即刻动度在I°范围内.影像学检查显示:移植牙远中骨缺损得到填充修复,近中与邻牙邻接良好.结论:低位阻生第三磨牙自体移植至第二磨牙可以成为自体牙移植术的适应证,采用海奥口腔修复膜复合骨填充材料能够提高伴有骨缺损的移植牙的术后即刻稳定性.

AIM： To fill the bone defects with heal-all biological membrane combined bone filling material when autotransplanting the low site impacted third molar to the second molar. METHODS： Alveolar bone resorption caused by various reasons of the mandibular second molar lesions cannot be preserved,and the conventional treatment was low in adjacent teeth or horizontally impacted third molars for two teeth extraction,or later implant denture. The autotransplantation was also not the indication since the fixation was difficult and the mobility is not enough because of the bone defect. In this study,the innovative method was to use the artificial bone filling material（ Spongious Bone substitute,Bio-oss,Geistlich,Switzerland or Calcined Bovine Bone,Rui Sheng,China） to fill the buccal and distal bone defect area. Then the heal-all biological membrane（ Zheng Hai,China） was cut out and suppressed as a film to cover the surface of the material. Twisted metal wire was used for the elastic fixation after the suture and cover periodontal dressings in wound for protection. RESULTS：The autotransplanted tooth was well-fixed,and the instant mobility was within the I° range. Imaging examination showed the distal bone defect of the transplanted tooth was filled and repaired.CONCLUSION： Transplanting the low site impacted third molar to the second molar could be the indication of autotransplantation.Heal-all biological membrane combined bone filling material could improve the instant stability of the transplanted teeth with buccal and distal bone defects.