异种成型胶原骨引导种植体周围骨缺损再生的临床研究

doi:10.13591/j.cnki.kqyx.2023.04.007

摘要/Abstract

摘要：

目的前瞻性评价软块状含10%胶原的去蛋白无机牛骨(DBBM-C)与颗粒状去蛋白无机牛骨(DBBM)引导种植体周围骨缺损再生的骨体积变化和稳定性差异。方法通过牙槽骨缺损与预期种植体植入位点的关系将缺损分为Ⅰ-0的拟种植位点(18个)进行种植一期手术,种植体放置后颊侧出现5~8 mm“V”型骨开裂,同期行引导性骨再生术(GBR),试验组(DBBM-C组)10个,采用DBBM-C+胶原膜(CM),对照组(DBBM组)8个,采用DBBM+CM。术后即刻、术后6个月和术后12个月,CBCT分析测量种植体唇颊侧颈部水平骨厚度(d)、45°骨厚度(d₄₅)和骨高度(h)。结果两组术后即刻d、d₄₅和h数值不同,差异无统计学意义;术后6个月和12个月DBBM-C组d和d₄₅数值均高于DBBM组,差异有统计学意义(P<0.05),h值组间差异无统计学意义;术后即刻-术后6个月d和d₄₅变化值,DBBM-C组低于DBBM组,差异有统计学意义(P<0.05),h变化值组间差异无统计学意义;术后6个月-术后12个月d、d₄₅和h变化值,两组差异无统计学意义。结论在本研究中,DBBM-C+CM在引导种植体周围骨缺损再生的骨体积变化小于DBBM+CM,DBBM-C+CM在引导种植体周围骨缺损再生的稳定性优于DBBM+CM。

关键词: 骨替代材料, 引导性骨再生(GBR), 骨体积变化, 稳定性差异

Abstract:

Objective To conduct prospective evaluation of bone volume changes and stability differences between regeneration of peri-implant bone defects guided by soft block-shaped deproteinized inorganic bovine bone containing 10% collagen(DBBM-C) and granular deproteinized inorganic bovine bone(DBBM). Methods Implant surgery was performed on the proposed implant sites(18), which were classified asⅠ-0 by the relationship between the alveolar bone defect and the expected implant placement site. “V” shaped bone dehiscence 5-8 mm occurred on the buccal side after implant placement, and guided bone regeneration(GBR) was done simultaneously, with 10 DBBM-C + collagen membrane(CM) and 8 DBBM+CM. Immediately after surgery, six months after surgery and twelve months after surgery, CBCT was performed and analyzed to measure the horizontal bone thickness(d), 45° bone thickness(d₄₅)and bone height(h) of the labial and buccal side of the implant at cervical level. Results Values of d, d₄₅ and h immediately after surgery were different between the two groups, and the differences were not statistically significant; values of d and d₄₅ in the DBBM-C group were higher than those in the DBBM group at 6 and 12 months postoperatively (P<0.05), and the differences were statistically significant. Differences between groups in h values were not statistically significant. Values of d and d₄₅ changes from the immediate postoperative period to 6 months after surgery were lower in the DBBM-C group, and the differences were statistically significant. The difference in changes of h values between the two groups was not statistically significant; the difference between the two groups was not statistically significant in d, d₄₅ and h change values from 6 months to 12 months after surgery. Conclusion In this study, DBBM-C+CM showed less bone volume change than DBBM+CM in guiding the regeneration of peri-implant bone defects and had better stability.

Key words: bone replacement material, guided bone regeneration (GBR), bone volume change, stability difference

中图分类号:

R782.1

李佳芙,吕红,周静,刘情,蒲奕名,卜鸿鹄,刘清辉,曲彬彬. 异种成型胶原骨引导种植体周围骨缺损再生的临床研究[J]. 口腔医学, 2023, 43(4): 322-326.

LI Jiafu,LYU Hong,ZHOU Jing,LIU Qing,PU Yiming,BU Honghu,LIU Qinghui,QU Binbin. Clinical study on allogeneic molded collagen bone to guide the regeneration of peri-implant bone defects[J]. Stomatology, 2023, 43(4): 322-326.

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组别	术后即刻	术后6个月	术后12个月	术后6个月-术后即刻	术后12个月-术后6个月
DBBM-C组	2.66±1.00	2.22±0.91	1.97±0.80	-0.43±0.23	-0.27±0.14
DBBM组	2.49±0.69	1.32±0.50	1.13±0.46	-1.17±0.72	-0.19±0.08
P	0.691	0.021	0.018	0.003	0.149

组别	术后即刻	术后6个月	术后12个月	术后6个月-术后即刻	术后12个月-术后6个月
DBBM-C组	2.13±0.87	1.79±0.78	1.54±0.71	-0.34±0.13	-0.25±0.14
DBBM组	2.04±0.62	1.10±0.33	0.92±0.27	-0.94±0.39	-0.17±0.10
P	0.804	0.033	0.033	0.003	0.129

组别	术后即刻	术后6个月	术后1年	术后6个月-术后即刻	术后12个月-术后6个月
DBBM-C组	2.11±0.84	1.61±0.81	1.33±0.58	-0.51±0.25	-0.28±0.30
DBBM组	2.22±0.69	1.48±0.66	1.22±0.56	-0.74±0.57	-0.26±0.17
P	0.771	0.894	0.869	0.314	0.625