阻生第三磨牙联合生物材料移植修复第一磨牙的临床研究

Clinical study of the third impacted mandibular molar implantation combined with biomaterial transplantation in the repair of the first molar lost

目的:探讨辅助应用锥形束计算机断层扫描、3D打印技术和引导骨再生技术,开展下颌阻生第三磨牙完整拔除后联合生物材料移植修复缺失的下颌第一磨牙的临床疗效。方法:纳入下颌第一磨牙缺失,且同侧下颌第三磨牙阻生患者92例(患牙108颗)为对象,其入院时间均在2014年6月至2015年6月,按治疗方案分组。对照组患者42例(患牙52颗)采用常规修复技术;观察组患者50例(患牙56颗)辅助应用锥形束计算机断层扫描、3D打印技术,将下颌第三磨牙完整拔出后植入待修复区,联合应用生物材料移植引导骨再生。术后6月复查疗效,摄牙片及临床检查,评价移植牙松动度、牙根愈合情况、牙槽骨降低量。结果:观察组移植牙松动度分层对比,明显低于对照组,差异有统计学意义(P<0.05);2组均未见牙根吸收,观察组牙根骨性愈合率100%,对照组牙根骨性愈合率36.5%(19颗),差异有统计学意义(P<0.05);观察组牙槽骨降低量分层对比明显低于对照组,差异有统计学意义(P<0.05);观察组临床疗效分层对比明显优于对照组,差异有统计学意义(P<0.05)。结论:对第一磨牙缺失患者,应用阻生第三磨牙结合生物材料移植修复,效果确切,适宜推广。

Objective： To investigate the effect of repair first molar lost by third impacted mandibular molar implantation combined with biomaterial transplantation, with the assist of cone beam computed tomogra-phy （CBCT）, 3D printing technology and guided bone regeneration technique. Methods： 92 cases （108 teeth） of the patients, who were hospitalized during June 2014 to June 2015, with mandibular first molar lost and third molar impacted in the same side were involved. According to the therapy, they were di-vided into 2 groups. 42 cases（52 teeth） in the control group were treated with conventional repair tech-nology. 50 cases （55 teeth） in the observation group were treated by third impacted mandibular molar implantation combined with biomaterial transplantation, with the assist of cone beam computed tomogra-phy（CBCT）, 3D printing technology and guided bone regeneration technique. After 6 months of follow-up, the curative effect, transplanted tooth mobility, root healing, reduction of alveolar bone were com-pared. Results： In the observation group, the transplanted tooth mobility was significantly less than in the control group, the difference was statistically significant （P＆lt;0.05）. There were no root resorption in both groups, the bone healing rate in the observation group was 100.0%, which was higher than in the control group（36.5%）, the difference was statistically significant （P＆lt;0.05）. Reduction of alveolar bone in the observation group was significantly less than in the control group, the difference was statistically significant （P＆lt;0.05）. The clinical curative effect in the observation group was better than in the control group, the difference was statistically significant（P＆lt;0.05）. Conclusion：For patients with first molar lost, the application of impacted mandibular third molar implantation combination with biomaterial transplan-tation is effective and feasible.