上颌磨牙位点保存两种创口封闭方式的临床效果比较

Comparison of the clinical effects of two different wound closure methods in extraction site preservation of maxillary molars

目的研究浓缩生长因子(concentrated growth factor,CGF)和游离龈移植(free gingival graft,FGG)分别与Bio-Oss Collagen联合应用于上颌磨牙拔牙位点保存的临床效果。方法选取需要拔除上颌磨牙的患者30例,拔牙后填入Bio-Oss Collagen,随机分为两组,A组覆盖CGF封闭创口,B组使用FGG封闭创口,术后观察创面愈合情况,半年后测量颊侧角化龈宽度变化,拍摄CBCT测量牙槽骨和上颌窦底变化。结果术后1周和2周时,B组创面愈合率均高于A组(P<0.05);术后6个月,A组和B组颊侧角化龈宽度分别减少了(0.79±0.16)mm和(0.35±0.18)mm(P<0.05)。两组术后即刻和术后6个月牙槽骨宽度变化差值、颊腭侧牙槽骨高度变化差值和上颌窦底高度变化差值均无显著性差异(P>0.05)。结论上颌磨牙拔除后,植入Bio-Oss Collagen联合CGF或FGG行拔牙位点保存均可有效减少牙槽骨吸收,两者术后牙槽骨和上颌窦底变化没有显著差异,B组术后创面愈合率和颊侧角化龈减少量优于A组。

Objective To assess the clinical effects of concentrated growth factor(CGF)and free gingival grafting(FGG)in combination with Bio-Oss Collagen in extraction site preservation after maxillary molar extraction.Methods Thirty patients were randomly divided into two groups.The tooth sockets were filled with Bio-Oss Collagen,and then the wounds were closed using either CGF or FGG.Postoperative wound healing and the width of keratinized gingival tissue were observed,while CBCT was used to evaluate the changes in the alveolar bone and maxillary sinus floor.Results Group B exhibited a higher rate of wound healing compared to group A(P<0.05).The width of keratinized gingival decreased by(0.79±0.16)mm in group A and(0.35±0.18)mm in group B,respectively(P<0.05).There was no significant difference between the two groups regarding changes in alveolar bone or maxillary sinus floor(P>0.05).Conclusion Both CGF and FGG combined with Bio-Oss Collagen effectively reduced bone resorption during ridge preservation after maxillary molar extraction,with no significant differences observed in alveolar bone or maxillary sinus floor changes between the two groups.However,FGG demonstrated better wound healing rates and less reduction of buccal keratinized gingival compared to CGF.