重组人骨形态发生蛋白-2用于骨壁缺损拔牙位点保存的效果

Study on Efficacy of rhBMP-2 for Extraction Sockets Preservation with Bone Wall Defect

目的:评价重组人骨形态发生蛋白-2(recombinant bone morphogenetic proteinrh-2,rhBMP-2)用于骨壁缺损拔牙位点保存的临床效果。方法:2019年2月~2023年1月将符合条件的142例患者随机分组,A组使用rhBMP-2+胶原蛋白海绵填充拔牙窝,B组使用胶原蛋白海绵,C组不使用移植物。于拔牙后18周、24周开展种植手术,并编为A1、A2;B1、B2;C1、C2组,种植术中发现有牙槽嵴顶骨缺损的病例测量牙槽嵴缺损的最大近远中径(L)、颊舌径(W)及深度(H),计算体积(V)值(V=L×W×H);无牙槽骨顶骨缺损的病例取种植窝骨块进行组织学分析。结果:A1、A2组牙槽嵴顶骨缺损的发生频率分别为:0.32、0.14;B1、B2组分别为:0.75、0.43;C1、C2组分别为:0.72、0.37。A1B1组间、A2B2组间、A1C1组间及A2C2组间V值差异有统计学意义(P<0.05)。A1B1组间及A1C1组间新生骨占比差异有统计学意义(P<0.05)。结论:rhBMP-2用于骨壁缺损的拔牙位点保存可缩短成骨时间(18周),减少不良愈合的发生,为后期种植手术的开展创造更有利的骨条件。

Objective:To evaluate the efficacy of recombinant human bone morphogenetic protein-2(rhBMP-2)for alveolar ridge preservation with bone wall defect.Methods:From February 2019 to January 2023,142 eligible patients were randomly divided into group A using rhBMP-2+collagen sponge to fill the extraction sockets,group B using collagen sponge alone,and group C using no grafts.The implant surgery was carried out at 18 and 24 weeks after tooth extraction,and three groups were divided into group A1,A2;B1,B2;and C1,C2.Maximum meso-distal and buccal-lingual diameter(L,W)and depth(H)of alveolar crest defect were measured in cases of alveolar ridge bone defects found during implant surgery,and V values were calculated(V=L×W×H).Bone blocks of implant sockets were obtained for histological evaluation in cases without alveolar bone defects.Results:The frequency of alveolar ridge bone defects in group A1 and A2 were 0.32 and 0.14;in group B1 and B2 were 0.75 and 0.43;and in group C1 and C2 were 0.72 and 0.37,respectively.There were significant differences between group A1 and B1;between group A2 and B2;between group A1 and C1,and between group A2 and C2 in V value(P<0.05).There were significant differences between group A1 and B1 and between group A1 and C1 in new bone percentage(P<0.05).Conclusion:The use of rhBMP-2 for alveolar ridge preservation with bone wall defect can shorten the time of osteogenesis(18 weeks),reduce the frequency of erratic healing,and provide a favorable bone condition for subsequent implantation.