CGF聯合骨代用品在美學區拔牙位點保存中的臨床應用

朱梅 孫強 鄧佳蘊

[摘要]目的：探討濃縮生長因子（Concentrate growth factors，CGF）聯合骨代用品在美學區拔牙位點保存中的應用。方法：選取2016年1月-2018年1月在筆者醫院接受美學區域拔牙且需行種植修復的患者52例（共52顆患牙），按隨機數字表法將患者分為實驗組和對照組，每組26例。兩組均采用微創拔牙法，對照組拔牙后讓拔牙窩自然愈合，實驗組采用CGF位點保存聯合Bio-Oss骨代用品修復。比較兩組拔牙位點愈合、植骨及種植體保存情況和手術前后拔牙位點骨板高度及牙槽骨高度。結果：實驗組患者拔牙位點植骨區均愈合良好，附著齦充足，外形豐滿;對照組患者拔牙位點愈合良好，但牙槽嵴呈現不同程度的萎縮，且附著齦相對較窄。隨訪12個月，實驗組未行植骨手術的比例明顯高于對照組（P<0.05）。與術前比較，術后6個月對照組腭側、唇側骨板高度及兩組牙槽骨高度均明顯減小，實驗組明顯大于對照組（P<0.05或P<0.01）;實驗組種植修復體牙間乳頭及齦緣高度均獲得良好保存。結論：拔牙同期采用CGF聯合骨代用品行拔牙位點保存，可降低骨增量手術比例，有效保存牙槽嵴頂寬度，提高術后美容效果，安全性高。

[關鍵詞]濃縮生長因子;骨代用品;美學區域;拔牙位點;保存;應用

[中圖分類號]R782.12 ? ?[文獻標志碼]A ? ?[文章編號]1008-6455（2019）11-0100-03

Abstract： Objective ?To investigate the application of concentrated growth factor （CGF） combined with bone substitute in the preservation of extraction site in aesthetic area. Methods ?52 patients （52 teeth） who received dental extraction in our hospital from January 2016 to January 2018 were selected and divided into the experiment group and the control group according to the random number table method， 26 cases in each group. Two groups were treated with minimally invasive extraction， the control group was naturally healed after tooth extraction， the experiment group was treated with CGF site preservation and Bio-Oss bone substitute. The situation of healing， bone graft and preservation of the implants of the extraction site， and the height of the bone plate， the width of the alveolar bone before and after the operation between the 2 groups were compared. Results ?In the experiment group， the bone grafting area of the extraction site healed well， the attachment was sufficient， and the shape was full， the extraction site of the control group healed well， but the alveolar ridge showed different degrees of atrophy and the attachment sputum was relatively narrow. After 12 months of follow-up， the proportion of no bone graft surgery in the experiment group was significantly higher than that in the control group （P<0.05）. Compared with preoperative， the height of the temporal， labial bone plates and the height of the alveolar bone significantly decreased of the 2 groups 6 months after the operation， and the experiment group was significantly larger than the control group （P<0.05 or P<0.01）. After 12 months of follow-up， the height of the interdental papilla and the rim of the experiment group preserved well. Conclusion ?CGF combined with bone substitute in the preservation of extraction site at simultaneous extraction of teeth can reduce the proportion of bone incremental surgery， effectively preserve the width of the alveolar dome， improve the cosmetic effect after surgery， and have high safety.

骨代用品Bio-Oss是以去有機質的牛四肢骨為原料加工制成的與人骨非常相似的替代骨材料，親水性強、生物相容性高、可塑性好，可促進成骨細胞附著成骨，引導新骨形成，且不易引起宿主過敏反應、炎性反應及免疫反應等，在骨缺損重建中有較好的應用價值，但可在一定程度上引起骨愈合延遲[10-11]。……