重度牙周炎后牙位点保存术中联合应用浓缩生长因子的疗效评价

Evaluation of the efficacy of combined application of concentrated growth factors in ridge preservation of teeth with severe periodontitis

目的:评价蛋白牛骨基质(deproteinized bovine bone matrix,DBBM)与浓缩生长因子(concentrated growth factor,CGF)联合用于重度牙周炎患牙位点保存中对牙槽骨三维轮廓的维持疗效。方法:选择后牙罹患重度牙周炎需要拔除,且有种植修复意向的患者30例,随机分为实验组和对照组,每组15例。实验组微创拔牙,彻底清创后,采用DBBM联合CGF液体作为骨移植材料置于拔牙窝内;对照组采用DBBM与生理盐水混合,作为骨移植材料。2组拔牙创口均覆盖可吸收生物膜和游离角化龈组织。初诊时、术后即刻、术后6个月进行CBCT扫描,将CT图像导入Mimics 20.0软件包,拟合后测量,获得数据,采用SPSS 26.0软件包对数据进行统计学分析。结果:实验组和对照组牙槽骨垂直高度术后6个月与初诊时相比显著增加(P<0.05),但2组间差异无统计学意义(P>0.05)。2组患者初诊时与术后6个月牙槽骨宽度在牙槽嵴顶下1 mm处的变化存在显著差异(P<0.05),实验组水平宽度吸收量小于对照组;实验组骨移植材料在牙槽嵴顶下1 mm处的水平吸收率显著小于对照组(P<0.05)。结论:与单独应用DBBM相比,DBBM和CGF联合应用可以更好维持重度牙周炎患牙拔牙窝的牙槽骨轮廓。

PURPOSE:To evaluate the efficacy of combination of deproteinized bovine bone matrix and concentrated growth factors in maintaining the three-dimensional contour of alveolar bone in ridge preservation of teeth with severe periodontitis.METHODS:Thirty patients with posterior teeth suffering from severe periodontitis requiring extraction and with the intention of implant restoration were selected and randomly divided into the experimental group and control group,with 15 cases in each group.In the experimental group,DBBM combined with CGF fluid was used as bone graft material and placed in the extraction socket of the patient after minimally invasive tooth extraction and thorough debridement,while DBBM was used in the control group mixed with normal saline as the bone graft material.The extraction wounds of both groups were covered with absorbable biofilm and free gingival tissue.CBCT was performed at the initial diagnosis,immediately after operation,and 6 months after operation,and the CT images were imported into Mimics 20.0 software package to measure the difference after fitting to obtain data,SPSS 26.0 software package was used for statistical analysis of the data.RESULTS:The vertical height of the alveolar bone in the experimental group and the control group was significantly increased 6 months after operation compared with the initial diagnosis(P<0.05),but there was no significant difference between the 2 groups(P>0.05).There was significant difference in the change of the alveolar bone width at 1 mm below the alveolar crest between the two groups at the initial diagnosis and 6 months after operation(P<0.05),and the horizontal width absorption in the experimental group was smaller than that in the control group.The horizontal absorption rate of bone graft material in the two groups at 1 mm below the alveolar crest showed that the experimental group was lower than the control group,and the difference was statistically significant(P<0.05).CONCLUSIONS:Compared with DBBM alone,combined application of DBBM and CGF can better maintain the alveolar bone contour of the extraction socket with severe periodontitis.