| 引用本文: | 吴婧,杨渊,黄鼎阳,姚颖冰,黄美娟,刘晓霞,王玲.同种异体骨联合富血小板纤维蛋白重建牙槽骨严重缺损的临床研究[J].中国临床新医学,,():-. |
| wujing.同种异体骨联合富血小板纤维蛋白重建牙槽骨严重缺损的临床研究[J].中国临床新医学,,():-. |
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| 同种异体骨联合富血小板纤维蛋白重建牙槽骨严重缺损的临床研究 |
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吴婧1,2, 杨渊3,2, 黄鼎阳1,2, 姚颖冰1,2, 黄美娟1,2, 刘晓霞1,2, 王玲1,2
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1.广西中医药大学第一附属医院 2.广西南宁市;3.广西医科大学第一附属医院
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| 摘要: |
| 目的:探究同种异体骨联合富血小板纤维蛋白（PRF）在重建牙槽骨严重缺损中的临床效果。方法:选取2021年10月—2024年9月广西中医药大学第一附属医院60例具有一颗或相邻两颗牙位牙槽骨严重缺损且接受同种异体骨移植及延期种植治疗的患者，采用随机数字表法分为对照组与实验组，各30例。对照组采用同种异体骨移植联合脱细胞真皮基质（ADM）口腔生物膜覆盖移植物进行骨重建；实验组采用同种异体骨与PRF混合移植联合ADM口腔生物膜覆盖移植物进行骨重建。通过牙槽骨形态学影像学评价、种植体稳定性值（ISQ）、种植体功能负荷周围软组织测量及不良反应观察等方式对两组患者进行疗效评估。结果:骨重建术后6个月，两组牙槽骨高度、宽度及骨密度均较术前显著改善（均P<0.05），且实验组牙槽骨高度、宽度及骨密度均显著高于对照组（均P<0.05）。种植术后3个月，实验组ISQ值较植入即刻显著升高（P<0.05），但对照组种植术后3个月与植入即刻的ISQ值比较差异无统计学意义（均P>0.05）；种植后3个月，实验组ISQ值显著高于对照组（P<0.05）。种植体功能负荷后3个月，实验组探诊深度（PD）、牙龈退缩量（GR）、牙龈指数（GI）均显著低于对照组，角化龈宽度（KTW）显著高于对照组（均P<0.05）。两组不良反应发生率比较差异无统计学意义（χ2=0.741，P=0.389）。结论:同种异体骨联合 PRF 重建牙槽骨严重缺损，可更显著改善牙槽骨形态与骨密度，提升种植体稳定性及周围软组织健康，且安全性与单纯同种异体骨移植相当，临床应用价值更高。 |
| 关键词: 牙槽骨严重缺损 同种异体骨 富血小板纤维蛋白 脱细胞真皮基质 种植体稳定性 |
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| Clinical study on reconstruction of severe alveolar bone defects with allogeneic bone combined with platelet-rich fibrin |
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wujing
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The First Affiliated Hospital of Guangxi University of Chinese Medicine
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| Abstract: |
| Objective: To investigate the clinical efficacy of allogeneic bone combined with platelet-rich fibrin (PRF) in reconstructing severe alveolar bone defects. Methods: Sixty patients with severe alveolar bone defects in one or two adjacent tooth positions, who underwent allogeneic bone grafting and delayed implant treatment at the First Affiliated Hospital of Guangxi University of Chinese Medicine from October 2021 to September 2024, were selected. Using a random number table, they were divided into a control group and an experimental group, each with 30 cases. The control group received allogeneic bone grafting combined with an acellular dermal matrix (ADM) oral biofilm to cover the graft for bone reconstruction. The experimental group received a mixture of allogeneic bone and PRF for grafting, combined with ADM oral biofilm coverage. Efficacy was evaluated through morphological and imaging assessments of alveolar bone, implant stability quotient (ISQ) measurements, peri-implant soft tissue measurements after functional loading, and observation of adverse reactions. Results: At 6 months post-bone reconstruction, both groups showed significant improvements in alveolar bone height, width, and bone density compared to preoperative levels (all P< 0.05), with the experimental group demonstrating significantly greater improvements in these parameters than the control group (all P< 0.05). At 3 months post-implantation, the ISQ values in the experimental group increased significantly compared to immediate post-implantation values (P< 0.05), while no significant difference was observed in the control group between immediate and 3-month ISQ values (all P> 0.05). At 3 months post-implantation, the experimental group had significantly higher ISQ values than the control group (P< 0.05). At 3 months after functional loading, the experimental group had significantly lower probing depth (PD), gingival recession (GR), and gingival index (GI), and significantly greater keratinized tissue width (KTW) than the control group (all P< 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (χ2 = 0.741, P= 0.389). Conclusion: The combination of allogeneic bone and PRF for reconstructing severe alveolar bone defects can more significantly improve alveolar bone morphology and density, enhance implant stability and peri-implant soft tissue health, with safety comparable to allogeneic bone grafting alone, indicating higher clinical application value. |
| Key words: severe alveolar bone defect allogeneic bone platelet-rich fibrin acellular dermal matrix implant stability quotient |
