条形自体块状骨联合GBR在水平骨增量中的应用研究

doi:10.13591/j.cnki.kqyx.2023.05.011

摘要/Abstract

摘要：

目的比较条形自体块状骨联合引导骨再生(guided bone regeneration,GBR)与单纯GBR应用于水平骨增量的临床疗效。方法选择需先行水平骨增量延期种植的患者20例,随机分为2组,研究组(A组)为条形自体块状骨联合GBR,对照组(B组)为单纯GBR。在术前(T₀)、术后即刻(T₁)和术后6个月(T₂)利用锥形束CT(cone-beam computed tomography,CBCT)测量植骨区不同位点的牙槽嵴宽度,评价两组成功率、骨增量、骨吸收率和VAS疼痛评分。结果植骨术后6个月,两组成功率均为100%;骨宽度均明显增加,在嵴顶下1 mm和3 mm处A组相较B组多,具有显著性差异(P<0.05),在嵴顶下6 mm和9 mm无显著性差异(P>0.05);骨吸收率A组较B组在嵴顶下1 mm、3 mm和6 mm处小,具有显著性差异(P<0.05),在嵴顶下9 mm处相近,无显著性差异(P>0.05)。两组VAS疼痛评分差异无统计学意义(P>0.05)。结论对于严重水平向骨缺损,应用条形自体块状骨联合GBR较单纯GBR在嵴顶和中段处吸收率低,可获得更佳的骨嵴顶轮廓。

关键词: 自体块状骨移植, 水平骨增量, 引导骨再生

Abstract:

Objective To compare the clinical effects of strip autogenous bone block combined with GBR (guided bone regeneration) and GBR alone in horizontal bone augmentation. Methods Twenty patients who needed delayed implantation of horizontal bone augmentation were selected and divided into two groups. The study group(group A)was strip autogenous bone block combined with GBR, and the control group(group B) was GBR alone. Before operation(T₀), immediately after operation(T₁) and 6 months after operation(T₂), the width of different sections of alveolar ridge in the bone graft area was measured by cone beam computed tomography(CBCT). The graft success rate, bone increment, bone resorption rate and The VAS pain scale scores of two groups were evaluated. Results Six months after bone grafting, the success rate of two groups was 100%,andthe bone width in both groups was significantly increased. The increment of group A at 1 mm and 3 mm below the crest was more than that of group B, with a significant difference(P<0.05), while there was no significant difference at 6 mm and 9 mm below the crest(P>0.05). The absorption rate of group A was lower than that of group B at 1 mm, 3 mm and 6 mm below the crest, with a significant difference(P<0.05), while the bone absorption rate of two groups at 9 mm below the crest was similar, with no significant difference(P>0.05).There was no significant difference in pain scale scores between two groups(P>0.05). Conclusion For severe horizontal bone defect, application of strip autogenous bone block combined with GBR has a lower absorption rate at the crest and middle of alveolar ridge, and can get a better crest contour than that of GBR alone.

Key words: autologousbone block graft, horizontal bone augmentation, guided bone regeneration

中图分类号:

R782.13

何修全,李玉山,水宇豪,刘堃. 条形自体块状骨联合GBR在水平骨增量中的应用研究[J]. 口腔医学, 2023, 43(5): 451-455.

HE Xiuquan,LI Yushan,SHUI Yuhao,LIU Kun. Research on the application of strip autologous bone block combined with GBR in horizontal bone augmentation[J]. Stomatology, 2023, 43(5): 451-455.

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参考文献 21

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分组	年龄/岁	性别		缺牙数		缺牙部位				距牙槽嵴顶不同距离各部位的术前骨宽度/mm
分组	年龄/岁	男	女	单牙	多牙	前牙	后牙	上颌	下颌	距离1 mm	距离3 mm	距离6 mm	距离9 mm
A组	36.3±13.1	5	5	0	10	8	2	7	3	2.99±0.62	3.73±0.96	4.65±1.67	6.02±1.77
B组	27.7±8.6	5	5	3	7	8	2	6	4	3.30±0.98	4.09±1.34	5.19±1.58	6.44±1.67
P	0.100	0.211						1.000		0.408	0.499	0.467	0.592

嵴顶下距离	分组	即刻骨增量/mm	P	最终骨增量/mm	P	骨吸收率	P
1 mm	A组	4.43±1.49	0.270	3.67±1.02	0.002^*	15.9%	0.000^*
1 mm	B组	3.75±1.16	0.270	2.06±0.94	0.002^*	47.1%	0.000^*
3 mm	A组	5.68±1.63	0.133	4.35±0.88	0.003^*	21.6%	0.006^*
3 mm	B组	4.54±1.61	0.133	2.58±1.41	0.003^*	48.0%	0.006^*
6 mm	A组	5.34±2.05	0.205	4.42±1.46	0.051	15.4%	0.017^*
6 mm	B组	4.26±1.59	0.205	3.02±1.53	0.051	32.2%	0.017^*
9 mm	A组	4.49±2.18	0.282	3.57±1.79	0.291	21.4%	0.901
9 mm	B组	3.53±1.67	0.282	2.78±1.44	0.291	22.3%	0.901