预成型钛网在美学区引导骨再生的短期临床效果观察

Clinical observation of implantation of maxilla anterior teeth with preformed titanium mesh

目的:观察预成型钛网在上前牙种植时重建唇侧骨板重度缺损的短期临床效果。方法:唇侧骨板重度缺损的前牙种植患者,术中用预成型钛网维持成骨空间,联合骨粉、富血小板纤维蛋白(platelet rich fibrin,PRF)和胶原膜引导骨再生(guided bone regeneration,GBR)。CBCT测量二期手术时、修复后6个月、1年及2年植体唇侧的骨厚度及边缘骨高度。红色美学指数(pink esthetic score,PES)对修复后各个时期的软组织进行评分。所获数据进行单因素方差分析和SNK-q检验分析。结果:二期手术时、修复后6个月、1年及2年唇侧的骨厚度分别为(:3.08±0.32、3.03±0.21、2.99±0.19、2.99±0.17)mm,边缘骨高度降低量分别为:高于顶端(0.51±0.12、0.69±0.12、0.69±0.15)mm。统计分析显示1年内骨厚度、骨高度变化有统计学意义(P<0.05),而1年后趋于稳定。各个时期的PES评分与骨量的变化基本一致。结论:在前牙美学区种植存在重度骨缺损时联合使用预成型钛网、胶原膜和PRF引导骨再生的成骨效果显著、稳定,是一种有效的骨增量方法。

Objective:To explore the effect of preformed titanium mesh in repairing severe defects of maxilla labial cortex during implantation of anterior teeth.Methods:When patients with severe maxilla labial bone defect,preformed titanium mesh was used to maintain the space of bone graft,combined with collagen membrane,bone powder and PRF to guide bone regeneration.CBCT was used to measure the height of margin bone around implants and the thickness of bone at implants lingual side at the time of the second stage surgery,6 months,1 year and 2 years after restoration respectively.And the pink esthetic score(PES)was measured after restoration.The data were analyzed by one-way ANOVA and SNK-q test.Results:The thickness of the labial bone was 3.08±0.32、3.03±0.21、2.99±0.19、2.99±0.17 mm at the time of the second stage operation,6 months,1 year and 2 years after restoration,respectively.The height of the marginal bone around implants was higher than the top,0.51±0.12、0.69±0.12、0.69±0.15 mm at the time of the second stage operation,6 months,1 year and 2 years after restoration,respectively.Statistical analysis showed that the changes of bone thickness and height were statistically significant within one year,but tended to be stable after one year,and the PES result was same as this.Conclusion:It is an effective bone augmentation method to use titanium mesh when implantation of maxillary anterior teeth with severe bone defects.