前牙拔牙位点保存术后牙槽嵴软硬组织变化的临床研究

›› 2019, Vol. 39 ›› Issue (1): 20-24.

前牙拔牙位点保存术后牙槽嵴软硬组织变化的临床研究

承峥¹,孙秋望月¹,葛昕¹,王晨星¹,李怀奇¹,叶金海²,李中连¹

1. 南京医科大学口腔疾病研究江苏省重点实验室
2. 南京医科大学附属口腔医院口腔颌面外科

收稿日期:2018-08-20 修回日期:2018-10-24 出版日期:2019-01-28 发布日期:2019-01-28
通讯作者: 叶金海 E-mail:yjh98001@163.com
基金资助:
国家自然基金

Clinical research on changes of soft and hard tissue after the preservation in the front tooth extraction sites

Received:2018-08-20 Revised:2018-10-24 Online:2019-01-28 Published:2019-01-28

摘要/Abstract

摘要： 目的采用锥形束CT（cone beam computed tomography，CBCT）和模型间接测量法评价前牙拔牙同期位点保存6个月后牙槽嵴骨量及软组织量的变化。方法纳入29名患者共32颗符合拔牙适应症的前牙，实验处理组牙拔除术后应用去骨蛋白牛骨基质（deproteinizedboving bone mineral，DBBM，Bio-Oss?）和可吸收生物膜（海奥）进行拔牙位点保存术，对照组行常规拔牙术后未予特殊处理。全部患者拔牙术前取石膏模型，术后即刻及术后6个月拍摄CBCT并再次取石膏模型，通过CBCT和模型测量对比分析术后6个月牙槽骨及软组织高度和宽度的变化。结果通过CBCT测量结果对比，牙槽骨高度在唇侧和腭侧牙槽骨的高度测量结果差异有统计学意义（P<0.05）。术后6个月后实验处理组唇侧和腭侧牙槽骨高度显著高于对照组（P<0.05），分别为16.31± 0.94mm和18.61 ± 1.10mm，牙槽骨宽度在根长的20%、70%测量值也显著高于对照组（P<0.05），分别为4.43 ± 0.32mm和4.79 ± 0.37mm，但在根长50%处两种方法测量结果差异无统计学意义（P>0.05）。软组织高度在上颌牙龈缘最高点及下颌牙龈缘最低点处对照组（9.26 ± 0.40 mm）显著高于处理组（P<0.05），但在近中龈乳头、远中龈乳头处软组织两组间无显著统计学差异（P>0.05）。结论前牙拔牙同期进行位点保存术处理，对拔牙后牙槽嵴高度、宽度和牙龈软组织的保存均具有积极意义，值得临床实践中推广。

关键词: 拔牙位点保存, 牙槽嵴高度及宽度, 软组织高度

Abstract: Objective To evaluate the changes of alveolar bone and soft tissue after 6 months of the front tooth extraction site preservation by cone beam computed tomography (CBCT) and model measurement. Method A total of 32 teeth from 29 patients with indications for the front tooth extraction were enrolled. Deproteinized boving bone mineral (DBBM, Bio-Oss) and absorbable biofilm (Hao) were used in experimental group, when the extraction site was performed, and the control group received no special treatment after routine extraction. The gypsum model was employed before the operation (baseline) and after six months, while the CBCT was taken immediately after the operation (baseline) and six months later as well. The changes of alveolar bone and soft tissue were analyzed by CBCT and model measurement. Results The data obtained by CBCT were statistically significant in height of labial and temporal alveolar bone(P<0.05). After 6 months, the labial and temporal alveolar bone height of the experimental group was significantly higher than that of the control group (P<0.05), which were 16.31± 0.94m and 18.61 ± 1.10mm respectively. The alveolar bone width, measured at 20% and 70% of the root length, were also significantly higher than the control group (P<0.05), which were 4.43 ± 0.32mm and 4.79 ± 0.37mm respectively, but there was no significant difference between two groups at 50% of the root length (P>0.05). The soft tissue was significantly higher in the control group (9.26 ± 0.40 mm) than the treatment group (P < 0.05) at the highest point of the maxillary gingival margin and the lowest point of the mandibular gingival margin, but in soft tissue between mesial papilla and distal nipple, there was no statistically significant difference (P>0.05). Conclusions The simultaneous preservation of extraction sites of the front teeth have positive significance for the preservation of height, width and alveolar soft tissue after tooth extraction, which is worthy of promotion in clinical practice.

Key words: Extraction site preservation, Height and width of alveolar ridge, Height of soft tissue

中图分类号:

R782.11

承峥孙秋望月葛昕王晨星李怀奇叶金海李中连. 前牙拔牙位点保存术后牙槽嵴软硬组织变化的临床研究[J]. , 2019, 39(1): 20-24.

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