不同胶原型骨粉应用于拔牙后牙槽骨缺损修复的随机对照研究

Application of different collagen-type bone graft for the repair of alveolar bone defect after tooth extraction:a randomized controlled clinical trial

目的:评价新型胶原型人工骨粉应用于单颗牙拔除后牙槽骨缺损的修复效果。方法:选取就诊于南京医科大学附属口腔医院口腔颌面外科的89例单颗磨牙需拔除患者,随机分为2组,实验组在拔牙后即刻植入新型胶原型人工骨粉,对照组植入Bio-Oss Collagen,应用可吸收生物膜严密关创。术后当天和术后6个月拍摄锥形束CT(cone beam CT,CBCT),测量相应的牙槽骨高度、宽度及密度值,进行统计分析;期间3次随访观察创口愈合情况。结果:CBCT测量显示,实验组与对照组牙槽骨高度和宽度的变化量差异无统计学意义(P>0.05);术后6个月与术后当天比较,实验组颊侧骨高度及宽度无明显变化,舌(腭)侧骨高度降低(0.75±0.95)mm,对照组颊侧骨高度降低(0.54±1.47)mm,舌(腭)侧骨高度降低(1.20±1.18)mm,宽度无明显变化;术后当天实验组骨密度大于对照组(P<0.01),术后6个月时两组骨密度无明显差异(P>0.05)。临床检查显示,两组在创口愈合评分上无明显差异。结论:对于单颗磨牙拔除患者,新型胶原型骨粉在拔牙后牙槽骨缺损修复上与Bio-Oss Collagen具有相似的作用,并且在颊侧骨高度保存上的效果略优于Bio-Oss Collagen。

Objective:To evaluate the effect of a new collagen-type artificial bone graft on the repair of alveolar bone defect after single tooth extraction.Methods:A total of 89 patients with a single molar planned to be extracted at our institution were included and randomly divided into two groups.The experimental group was implanted with the new collagen-type bone graft while the control group was implanted with Bio-Oss collagen immediately after tooth extraction.After then,all wounds were coated by the absorbable biological membrane.The height,width and density of alveolar bone were tested by CBCT immediately and 6 months after surgery,and clinical examinations were conducted three times during the period.Results:There was no significant difference in the change of alveolar bone height and width between the experimental group and the control group(P>0.05).In the experimental group,the lingual bone height decreased by(0.75±0.95)mm,while no significant change was found in the buccal bone height and the width.In the control group,the height decreased by(0.54±1.47)mm in the buccal and decreased by(1.20±1.18)mm in the lingual,whereas bone width did not change significantly.Bone density of the experimental group was higher than that of the control group immediately after surgery(P<0.01),but no significant differences were found between the two groups 6 months after surgery(P>0.05).Clinical examination showed that there was no significant difference in wound healing score between the two groups.Conclusion:The new collagen-type artificial bone graft has similar effects to Bio-Oss collagen on the repair of alveolar bone defect after extraction,and is slightly better in preservation of the buccal bone.