阻生齿拔除同期植骨术中用医用胶原蛋白海绵作为屏障膜对邻牙远中成骨效果的影响

Effect of medical collagen sponge as barrier membrane on the distal osteo genesis of adjacent teeth during simultaneous extraction of impacted teeth and bone grafting

目的:探讨并分析对下颌第三磨牙低位阻生并毗邻第二磨牙患者进行阻生齿拔除同期植骨术中用医用胶原蛋白海绵作为屏障膜对其第二磨牙远中成骨效果的影响。方法:选择2018年7月至2019年6月期间苏州口腔医院接诊的20例下颌第三磨牙低位阻生并毗邻第二磨牙患者作为研究对象。随机将其分为观察组(n=10)与对照组(n=10)。对两组患者均进行阻生齿拔除同期植骨术。术中为观察组患者使用医用胶原蛋白海绵作为屏障膜,为对照组患者使用可吸收生物膜作为屏障膜,然后比较两组患者术后发生拔牙窝感染的情况、创口愈合的情况、第二磨牙远中的牙周探诊深度(PD)及牙槽骨的高度。结果:两组患者均手术成功。术后2周,对照组患者未发生拔牙窝感染,其创口愈合良好;观察组患者中有9例患者的创口愈合良好,有1例患者发生轻度拔牙窝感染,经对症治疗后其创口于术后4周完全愈合。术后6个月,两组患者下颌第二磨牙远中的牙槽窝均较为平坦。术后6个月,两组患者第二磨牙远中的PD相比,差异无统计学意义(P>0.05)。术后6个月,两组患者下颌第二磨牙远中牙槽骨高度的增加量相比,差异无统计学意义(P>0.05)。结论:对下颌第三磨牙低位阻生并毗邻第二磨牙患者进行阻生齿拔除同期植骨术的过程中,采用医用胶原蛋白海绵作为屏障膜可有效地预防其术后出现第二磨牙远中牙槽骨吸收的情况,促进其第二磨牙远中骨组织的再生及修复。

Objective:To investigate and analyze the effect of using medical collagen sponge as barrier membrane on the distal osteogenic effect of the second molar in patients with lower impacted third molar adjacent to the second molar during the impacted tooth extraction and bone grafting.METHODS:From July 2018 to June 2019 in Suzhou Stomatological Hospital,20 patients with lower impacted third molars adjacent to the second molar were selected as the research subjects.They were randomly divided into observation group(n=10)and control group(n=10).Obstructed tooth extraction and bone grafting were performed in both groups.During the operation,medical collagen sponge was used as the barrier membrane for the observation group,and absorbable biofilm was used as the barrier membrane for the control group.After the operation,tooth extraction socket infection,wound healing,periodontal probing depth(PD)in the distal second molar and alveolar bone height were compared between the two groups.Results:The operation was successful in both groups.Two weeks after operation,no tooth extraction fossa infection occurred in the control group,and the wound healed well.In the observation group,9 patients had good wound healing,and 1 patient had mild tooth extraction fostis infection.After symptomatic treatment,the wound healed completely 4 weeks after operation.Six months after operation,the distal alveolar fossa of the second mandibular molar was relatively flat in both groups.At 6 months after operation,there was no significant difference in PD in distal second molar between the two groups(P>0.05).At 6 months after operation,there was no statistical significance in the increase of distal alveolar bone height of the second mandibular molar between the two groups(P>0.05).Conclusion:For patients with lower impacted third molar adjacent to the second molar,the use of medical collagen sponge as a barrier membrane can effectively prevent the resorption of distal alveolar bone of the second molar,and promote the regeneration and repair of distal bone tissue of the second molar.