重度牙周炎患者拔牙后使用CGF复合Bio-Oss骨胶原对牙槽骨的影响

Effects of CGF combined with Bio-Oss bone collagen on alveolar bone of post-tooth extraction in severe periodontitis patient

目的观察重度牙周炎患者患牙拔除后拔牙位点使用浓缩生长因子(CGF)复合Bio-Oss骨胶原保存术对牙槽骨的影响。方法将重度牙周炎且需要拔除患牙的患者均分为对照组(n=20)和实验组(n=20),两组术前均行系统牙周基础治疗,对照组常规微创拔牙,实验组在微创拔除后同期植入患者自体CGF复合Bio-Oss骨粉,并覆盖CGF膜严密缝合;术后第14 d和第30 d观察牙周软组织愈合情况,术后6月时使用锥形束X线计算机断层摄影(CBCT)测量两组患牙的拔牙窝深度(SD)及颊舌向骨宽度(BLW),计算手术前后牙槽骨高度差值(ΔSD)和增高率(SD%)、牙槽骨宽度差值(ΔBLW)和增宽率(BLW%),测量植骨区的骨密度变化。结果术后第30 d时,两组拔牙区域愈合良好,对照组牙槽嵴顶软组织部分塌陷,实验组拔牙槽宽度增加显著,牙槽骨形态丰满,牙龈颜色粉红、质地坚韧;术后6个月时,实验组ΔBLW、ΔSD值均大于对照组(P=0.01),牙槽骨BLW%和SD%高于对照组(P<0.05),拔牙槽窝区域的平均骨密度高于对照组(P=0.01)。结论在重度牙周炎患牙拔除后,使用CGF复合Bio-Oss骨胶原行拔牙创位点保存技术可以减少拔牙后牙槽骨的吸收,维持或增加牙槽骨嵴的骨量。

Objective To investigate the clinical effects of concentrated growth factor(CGF)combined with Bio-Oss bone collagen on alveolar bone wound after tooth extraction of periodontitis patients.Methods A total of 40 patients with severe periodontitis required extraction were divided into control group(n=20)and experimental group(n=20).All patients were treated with systemic periodontal basic treatment before operation.Control group was treated with conventional minimally invasive tooth extraction.Experimental group was implanted with autologous CGF combined with Bio-Oss bone powder after minimally invasive extraction,and covered with CGF film and tightly sutured.On the 14 th and 30 th day after operation,periodontal soft tissues healing was observed;6 months later,cone beam X-ray computed tomography(CBCT)was taken to detect changes of socket depth(SD)and buccal-lingual bone width(BLW)for calculating height difference of alveolar bone(ΔSD)and elevated rate(SD%),width difference of alveolar bone(ΔBLW)and widened rate(BLW%)as well as the bone density changes of bone implantation part before and after operation.Results On the 30 th day after operation,tooth extraction wound of both groups healed well.Alveolar ridge soft tissue partially collapsed in control group.Extraction wound of experimental group widened obviously.Morphological features of alveolar bone were plump,gingiva was pink and pliable in texture.Six months after operation,values ofΔBLW andΔSD were greater than that of control group(P=0.01).The widening rate of alveolar bone(BLW%)and the increasing rate of alveolar bone(SD%)in the experimental group were significantly higher than those of control group(P<0.05).The average bone density of extraction socket in the experimental group was higher than that of control group(P=0.01).Conclusion In post-tooth extraction caused by the severe periodontitis,the application of CGF combined with Bio-Oss collagen on extraction wound shows positive effects on preventing alveolar ridge resorption as well as maintaining or enhancing the amount of alveolar bone mass.