浓缩生长因子联合Bio-Oss骨粉在经牙槽嵴顶上颌窦提升术后种植中的应用
摘要
目的探讨浓缩生长因子联合Bio-Oss骨粉在上颌窦窦底骨量严重不足时种植治疗中的临床应用效果。方法选择2013年12月至2015年12月在惠州口腔医院就诊的骨量严重不足、需进行经牙槽嵴顶上颌窦提升术的27例患者,均需同期植入种植体,将其通过简单随机法分为实验组(15例)和对照组(12例)。实验组使用CGF联合Bio-Oss骨粉,对照组则直接使用Bio-Oss骨粉。术后2个月、4个月、6个月经CBCT测定上颌窦内距离种植体末端1 mm处的新形成骨骨密度(HU值)。结果实验组和对照组术前、术后2个月的HU值分别为(442.77±21.80)、(760.15±60.64)和(442.10±23.16)、(788.43±47.28),差异均无统计学意义(P>0.05),而术后4个月、6个月,实验组和对照组的HU值分别为(499.02±16.87)、(459.81±20.72)和(692.93±76.70)、(529.50±40.67),实验组优于对照组,差异均有统计学意义(P<0.05);与术前骨密度相比,实验组术后4个月骨密度已接近术前骨密度,对照组术后6个月骨密度才接近骨密度。结论在经牙槽嵴顶上颌窦提升术中CGF联合Bio-Oss骨粉作为骨替代材料的成骨能力明显高于单独应用Bio-Oss骨粉,为RBH严重不足需同期种植的患者提供一种临床参考。
引文
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[13]H?mmerle CH,Stone P,Jung RE,et al.Consensus statements and recommended clinical procedures regarding computer-assisted implant dentistry[J].International Journal of Oral&Maxillofacial Implants,2009,24(Suppl):126-131.
[14]Gu YX,Shi JY,Zhuang LF,et al.Transalveolar sinus floor elevation using osteotomes without grafting in severely atrophic maxilla:a5-year prospective study[J].Clinical Oral Implants Research,2014,27(1):120-125.
[15]Sartori S,Silvestri M,Forni F,et al.Ten-year follow-up in a maxillary sinus augmentation using anorganic bovine bone(bio-oss).Acase report with histomorphometric evaluation[J].Clinical Oral Implants Research,2003,14(3):369.
[16]Rodella LF,Favero G,Boninsegna R,et al.Growth factors,cd34 positive cells,and fibrin network analysis in concentrated growth factors fraction[J].Microscopy Research&Technique,2011,74(8):772.
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[19]Norton MR,Gamble C.Bone classification:an objective scale of bone density using the computerized tomography scan[J].Clinical Oral Implants Research,2001,12(1):79-84.
[2]Jr TH.Maxillary and sinus implant reconstructions[J].Dental Clinics of North America,1986,30(2):207.
[3]Summers RB.A new concept in maxillary implant surgery:the osteotome technique[J].Compendium-continuing Education for Veterinarians,1994,15(2):152,154.
[4]Lai HC,Zhang ZY,Wang F,et al.Resonance frequency analysis of stability on iti implants with osteotome sinus floor elevation technique without grafting:a 5-month prospective study[J].Clinical Oral Implants Research,2008,19(5):469.
[5]黄建生,周磊,宋光保.上颌窦提升植骨同期人工牙种植修复[J].中国口腔种植学杂志,2003,8(4):167-169.
[6]赖红昌,史俊宇.上颌窦提升术[J].口腔疾病防治,2017,25(1):8-12.
[7]Rosen PS,Summers R,Mellado JR,et al.The bone-added osteotome sinus floor elevation technique:multicenter retrospective report of consecutively treated patients[J].International Journal of Oral&Maxillofacial Implants,1999,14(6):853-858.
[8]Fornell J,Johansson L?,Bolin A,et al.Flapless,CBCT-guided osteotome sinus floor elevation with simultaneous implant installation.I:Radiographic examination and surgical technique.A prospective1-year follow-up[J].Clinical Oral Implants Research,2012,23(1):28-34.
[9]Dohan Ehrenfest DM,Rasmusson L,Albrektsson T.Classification of platelet concentrates:from pure platelet-rich plasma(p-prp)to leucocyte-and platelet-rich fibrin(l-prf)[J].Trends in Biotechnology,2009,27(3):158.
[10]黄娜,吴锋,李平,等.应用浓缩生长因子行上颌窦内提升后种植体周围骨变化[J].中国组织工程研究,2015,19(47):7575-7582.
[11]Ph D MDFB,Ph D SCD,Dds TW,et al.Implant survival rates after osteotome-mediated maxillary sinus augmentation:a systematic review[J].Clinical Implant Dentistry&Related Research,2012,14(14Suppl 1):e159-168.
[12]雷明辉,姬小婷,杨丹,等.原位植入并上颌窦内提同期种植治疗上颌后牙区牙缺失的临床研究[J].海南医学,2017,28(10):1605-1607.
[13]H?mmerle CH,Stone P,Jung RE,et al.Consensus statements and recommended clinical procedures regarding computer-assisted implant dentistry[J].International Journal of Oral&Maxillofacial Implants,2009,24(Suppl):126-131.
[14]Gu YX,Shi JY,Zhuang LF,et al.Transalveolar sinus floor elevation using osteotomes without grafting in severely atrophic maxilla:a5-year prospective study[J].Clinical Oral Implants Research,2014,27(1):120-125.
[15]Sartori S,Silvestri M,Forni F,et al.Ten-year follow-up in a maxillary sinus augmentation using anorganic bovine bone(bio-oss).Acase report with histomorphometric evaluation[J].Clinical Oral Implants Research,2003,14(3):369.
[16]Rodella LF,Favero G,Boninsegna R,et al.Growth factors,cd34 positive cells,and fibrin network analysis in concentrated growth factors fraction[J].Microscopy Research&Technique,2011,74(8):772.
[17]Dohan DM,Choukroun J,Diss A,et al.Platelet-rich fibrin(prf):Asecond-generation platelet concentrate.Part i:Technological concepts and evolution[J].Oral Surgery Oral Medicine Oral Pathology Oral Radiology&Endodontics,2006,101(3):e37-44.
[18]Sohn DS,Heo JU,Kwak DH,et al.Bone regeneration in the maxillary sinus using an autologous fibrin-rich block with concentrated growth factors alone[J].2011,20(5):389-395.
[19]Norton MR,Gamble C.Bone classification:an objective scale of bone density using the computerized tomography scan[J].Clinical Oral Implants Research,2001,12(1):79-84.