自体骨联合CGF在下颌阻生第三磨牙致第二磨牙远中骨缺损的应用
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摘要
目的探讨应用自体骨联合富自体浓缩生长因子纤维蛋白凝胶(CGF)在下颌阻生第三磨牙致第二磨牙远中骨缺损的应用价值。方法将符合纳入标准的阻生第三磨牙拔除术患者30例,采用随机左右侧分2组,研究组(A组30例)一侧采用超声骨刀设计块状去骨,术后将原位置骨块处理后,把自体碎骨混合CGF后置入第二磨牙远中牙槽窝处,用CGF双膜和异种脱细胞真皮基质(ECM)覆盖后缝合。对照组(B组30例)另一侧采用传统拔除术,术后直接缝合黏膜。对2组患者术后第二磨牙远中牙周袋深度及CBCT影像测量成骨高度等进行比较。结果术后6个月行临床检查2组患者第二磨牙远中牙周袋深度,A组:颊侧远中(3.26±0.69)mm,舌侧远中(3.12±0.65)mm;B组:颊侧远中(3.28±0.37)mm,舌侧远中(3.30±0.42)mm,2组患者比较差异无统计学意义(P>0.05);CBCT测量2组患者BAC至CEJ距离,A组分别为(4.48±1.21)mm、(4.46±1.10)mm、(4.26±0.75)mm;B组分别为(5.36±1.40)mm、(5.43±1.55)mm、(5.30±1.62)mm,2组比较差异有统计学意义(P<0.05)。结论自体骨联合CGF在下颌阻生第三磨牙致第二磨牙远中骨缺损的应用可促进远中硬组织的形成且增加第二磨牙远中成骨的高度。
Objective To explore the application value of autologous bone combined with CGF in the distal bone defect of the second molar with the third molar of mandibular obstruction. Methods 30 patients who pull out the maxillary third molar and met the inclusive criterion were randomly divided into two groups according to the left side and right side. The experimental group(group A,30 cases) was discarded the bone by ultrasonic osteotome. After blending the autologous bone with CGF,the mixture was placed the second molar alveolar socket. The double membrane CGF and heterogeneous decellularized dermal matrix(ECM) were covered,then the surface of wound was sutured. In the control group(group B 30 patients),the traditional removal was performed on the other side and the mucosa was sutured directly after the operation. The depth of periodontal pocket in the second molar and the height of the CBCT imaging were compared. between the two groups. Results The clinical examination and CBCT were underway six months after the operation. The depth of periodontal pocket in the second molar was measured. The distal cheek side was(3. 26 ± 0. 69) mm and the distal lingual side was(12 + 0. 65) mm in group A,the group B was(3. 28 ± 0. 37) mm and(3. 30 ± 0. 42) mm. There was no significant difference between the two groups(t =-0. 128,P > 0. 05). CBCT showed that the comparison between BAC and CEJ was(4. 48 + 1. 21) mm,(4. 46 ±1. 100) mm,(4. 26 ± 0. 75) mm in group A,and(5. 36 ± 1. 40) mm,(5. 43 ± 1. 55) mm,(5. 30 ± 1. 62) mm in group B. The difference between the two) groups was statistically significant(P < 0. 05). Conclusion the application of autologous bone combined withe CGF in mandible impacted maxillary third molar to the second molars can further promote the formation of hard tissues and increase the height of Osteogenesis in the second molars far.
Objective To explore the application value of autologous bone combined with CGF in the distal bone defect of the second molar with the third molar of mandibular obstruction. Methods 30 patients who pull out the maxillary third molar and met the inclusive criterion were randomly divided into two groups according to the left side and right side. The experimental group(group A,30 cases) was discarded the bone by ultrasonic osteotome. After blending the autologous bone with CGF,the mixture was placed the second molar alveolar socket. The double membrane CGF and heterogeneous decellularized dermal matrix(ECM) were covered,then the surface of wound was sutured. In the control group(group B 30 patients),the traditional removal was performed on the other side and the mucosa was sutured directly after the operation. The depth of periodontal pocket in the second molar and the height of the CBCT imaging were compared. between the two groups. Results The clinical examination and CBCT were underway six months after the operation. The depth of periodontal pocket in the second molar was measured. The distal cheek side was(3. 26 ± 0. 69) mm and the distal lingual side was(12 + 0. 65) mm in group A,the group B was(3. 28 ± 0. 37) mm and(3. 30 ± 0. 42) mm. There was no significant difference between the two groups(t =-0. 128,P > 0. 05). CBCT showed that the comparison between BAC and CEJ was(4. 48 + 1. 21) mm,(4. 46 ±1. 100) mm,(4. 26 ± 0. 75) mm in group A,and(5. 36 ± 1. 40) mm,(5. 43 ± 1. 55) mm,(5. 30 ± 1. 62) mm in group B. The difference between the two) groups was statistically significant(P < 0. 05). Conclusion the application of autologous bone combined withe CGF in mandible impacted maxillary third molar to the second molars can further promote the formation of hard tissues and increase the height of Osteogenesis in the second molars far.
引文
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[2]戈旌,杨驰,何冬梅,等.4种超声骨刀去骨法在高难度下颌阻生第三磨牙拔除术中的应用[J].中国口腔颌面外科杂志,2014,12(5):425-430.
[3]Vahid Rakhshan.Common risk factors for postoperativepain following the extraction of wisdom teeth[J].Korean Assoc Oral Maxillofac Surg,2015,41(2):59-65.
[4]尹东,俞海龙,王秀瑛,等.微创拔牙后即刻种植与延期种植的临床研究[J].宁夏医学杂志,2018,40(1):48-50.
[5]孟焕新.牙周病学[M].第4版.北京:人民卫生出版社,2012:68-71.
[6]方冬.锥形束CT用于评价离体牙槽骨高度准确性的研究[J].华西口腔医学杂志,2012,12(6):31-33.
[7]Chitsazi MT,Shirmohammadi A,Faramarzie M,et al.A clinical comparison of nano-crystalline hydroxyapatite(Ostim)and autogenous bone graft in the treatment of periodontal intrabony defects[J].Medicina Oral Patologia Oraly Cirugia Bucal,2011,16(3):448-453.
[8]Mozzati M,Gallesio G,Ullio L,et al.Patient-Based assessment of tooth extraction with ultrasonic dental surgery[J].Journal of Craniofacial Surgery,2014,25(6):2081-2083.
[9]姜志清,王兴强,赵秀,等.富血小板对阻生智齿拔除后邻牙远中牙周愈合的影响[J].牙体牙髓牙周病学杂志,2015,25(6):367-369.
[10]Leonardi DK,Haas L,Porporatti AL,et al.Diagnostic accuracy of cone-beam computed tomography and conventional radiography on apical periodontitis:a systematic review and meta-analysis[J].Journal of Endodontia,2016,42(3):356-364.