目的 比较β-磷酸三钙(β-tricalcium phosphate,β-TCP)和珊瑚羟基磷灰石(coral hydroxyapatite,CHA)在拔牙位点保存术中的临床效果。方法 纳入2013-06至2014-06于武警总医院口腔种植颌面外科拔除下颌磨牙的患者64例,随机分为4组,β-TCP组和CHA组各16例,拔牙同期分别植入两种骨代材料,植入组织补片(acellular dermal matrix,ADM)组16例,自然愈合组16例。测量拔牙前及6个月后牙槽嵴宽度及高度变化进行统计学分析,于6个月后种植术中取活检进行组织学观察。结果 两实验组牙槽嵴宽度及高度的吸收值显著低于自然愈合组和组织补片组(P＜0.05),两者间差异无统计学意义。β-TCP形成的新骨(39.85%±6.18%)比CHA(34.72%±6.52%)多(P＜0.05),但两者都显著低于组织补片组(45.15%±7.07%)和自然愈合组(46.37%±8.09%)(P＜0.05),组织补片组和自然愈合组两者间差异无统计学意义。结论 β-TCP和CHA联合组织补片应用于位点保存术皆可维持牙槽嵴骨量,在成骨方面β-TCP较CHA更有利。
Abstract
Objective To compare the clinical effects of two different guided bone tissue materials β-tricalcium phosphate and coral hydroxyapatite, on socket preservation. Methods 64 patients who needed to extract mandibular molar from June 2013 to June 2014 in General Hospital of Armed Police Forces were recruited into the study. All the patients were randomly divided into four groups, with 16 teeth in each. Two groups were implanted β-TCP and CHA, respectively, after tooth extraction. The remaining groups were set as ADM and blank control group. The width and height of the alveolar ridge were measured before and 6 months after tooth extraction for statistical analysis. A trephine core biopsy of the implant socket preparation was performed in implant placement after 6 months for histological observation. Results The bone absorption of two trial groups were significantly lower than that of other two groups (P<0.05), but there was no significant difference between themselves. The group of β-TCP showed more bone formation (39.85%±6.18%, P<0.05), whereas, they were both lower than other two groups significantly (ADM: 45.15%±7.07%; blank control group: 46.37%±8.09%, P<0.05); there was no significant difference between ADM and black control groups in bone absorption (P>0.05). Conclusions Application of β-TCP and CHA combined with acellular dermal matrix for socket preservation can obtain both good effects in preserving the bone quantity. In the aspect of osteogenesis, β-TCP is better than CHA.
关键词
拔牙 /
位点保存 /
β-磷酸三钙 /
珊瑚羟基磷灰石 /
组织补片
Key words
teeth extraction /
socket preservation /
β-tricalcium phosphate /
coral hydroxyapatite /
acellular dermal matrix
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