两种材料联合Bio-Oss®骨粉在后牙区拔牙位点保存术中的应用效果研究

Clinical evaluation of Bio-Oss® combined with two materials in alveolar ridge preservation of posterior teeth

目的评价浓缩生长因子(concentrated growth factor,CGF)膜和Bio-Oss®Collagen分别与Bio-Oss®骨粉联合应用于后牙区拔牙位点保存术中的效果。方法选取2020年11月至2021年3月于四川大学华西口腔医院种植科就诊的需拔除后牙并行位点保存术患者24例,随机分为CGF组和Collagen组,每组12例。所有患者拔牙后均填入Bio-Oss®骨粉,CGF组使用CGF膜覆盖拔牙创,Collagen组使用Bio-Oss®Collagen覆盖拔牙创。术后1周拆线观察创口愈合情况,术后6个月测量拔牙位点牙槽骨骨量及软组织厚度。结果术后1周,CGF组创口均愈合良好,Collagen组中有1例愈合不良,1/3骨粉流失。与术后即刻测量结果相比,术后6个月两组均发生一定程度骨吸收,CGF组垂直向骨吸收(0.98±1.53)mm,显著低于Collagen组[(2.78±1.60)mm],其差异有统计学意义(t=2.817,P<0.05);CGF组水平向骨吸收(1.83±1.11)mm,与Collagen组[(1.81±1.28)mm]相比,差异无统计学差异(t=-0.041,P>0.05)。与术前比较,术后6个月CGF组垂直骨高度增加(5.15±2.69)mm,Collagen组垂直骨高度增加(6.16±2.91)mm,差异无统计学差异(t=-0.883,P>0.05)。两组颊、腭侧软组织厚度均有所减小;但两组软组织变化量比较,差异均无统计学意义(均P>0.05)。结论本研究的2种材料在后牙区拔牙位点保存术中的应用效果均较好,覆盖于Bio-Oss®骨粉均可促进创口愈合,延缓牙槽骨吸收,对维持拔牙位点牙槽骨高度具有一定临床意义,利于后期种植修复。

Objective To compare the clinical efficacy between concentrated growth factor(CGF)membrane and Bio-Oss®Collagen combined with Bio-Oss®in alveolar ridge preservation(ARP)of posterior teeth.Methods From November 2020 to March 2021,24 patients with posterior teeth needed to undergo ARP in Department of Oral Implantology,West China Hospital of Stomatology,and they were selected and randomly divided into CGF group and Collagen group with 12 in each.CGF group used Bio-Oss®covered with CGF membrane while Collagen group used Bio-Oss®covered with Bio-Oss®Collagen to fill the socket.All patients were checked on the wound healing one week after the surgery.The soft tissue thickness and alveolar bone mass were checked 6 months later.Results One week after surgery,CGF group healed better than Collagen group.One case in Collagen group lost 1/3 Bio-Oss®.Both groups had a certain extent of bone resorption 6 months after surgery compared with that after surgery.The absorptivity in height of CGF group[(0.98±1.53)mm]was significantly lower than that of Collagen group[(2.78±1.60)mm](t=2.817,P<0.05).The absorptivity in width of CGF group was[(1.83±1.11)mm],while in Collagen group it was[(1.81±1.28)mm];there was no significant difference between them(t=-0.041,P>0.05).Compared with before surgery,the height of CGF group increased[(5.15±2.69)mm],while Collagen group increased[(6.16±2.91)mm]at 6 months after surgery;there was no significant difference between the two groups(t=-0.883,P>0.05).The thickness of buccal and palatal mucosa decreased in both groups.However,there was no significant difference in the changes of soft tissue between the two groups(P>0.05).Conclusion CGF and Bio-Oss®Collagen perform well in ARP.The Bio-Oss®covered with two materials can promote wound healing,decrease bone resorption and maintain the alveolar height,which is beneficial for later treatment.