個性化鈦網聯合屏障膜對上前牙骨缺損患者GBR修復效果及PES評分的影響

[摘要]目的：探討個性化鈦網聯合屏障膜對上前牙骨缺損患者引導骨再生（Guided bone regeneration，GBR）修復效果及紅色美學指數（Pink esthetic score，PES）評分的影響。方法：回顧性分析2020年12月-2022年5月筆者醫院就診的208例上前牙牙槽骨缺損患者病例資料，患者均行GBR術，根據術中應用膜材料的不同分成屏障膜組（103例）和復合組（105例）。屏障膜組術中使用屏障膜，復合組在屏障膜組基礎上聯合個性化鈦網。了解患者牙槽骨寬度及高度變化，評定患者PES評分，同時觀察并發癥發生情況。結果：術后當日、6個月，兩組牙槽骨寬度及高度均大于術前（P＜0.05），兩組術后6個月牙槽骨寬度及高度均較術后當日有所減小（P＜0.05），復合組術后6個月牙槽骨寬度及高度均大于屏障膜組（P＜0.05）；術后3個月、6個月，兩組PES評分均低于術后當日（P＜0.05），兩組術后6個月PES評分均較術后3個月降低（P＜0.05），但復合組術后6個月PES評分高于屏障膜組（P＜0.05）；復合組并發癥發生率（3.81%）和屏障膜組（5.83%）比較差異無統計學意義（P＞0.05）。結論：在上前牙骨缺損患者GBR術中使用個性化鈦網聯合屏障膜，對骨缺損的修復效果較好，有利于提高牙齦美觀效果，且安全性高。

[關鍵詞]個性化鈦網；屏障膜；上前牙骨缺損；引導骨再生

[中圖分類號]R783.4" " [文獻標志碼]A" " [文章編號]1008-6455（2024）12-0148-04

The Effect of Personalized Titanium Mesh Combined with Barrier Membrane in GBR Repair for Patients with Upper Anterior Teeth Bone Defects and Its Impact on PES Score

WU Fuyu， YANG Yajing， ZHENG Na， WANG Juan， TANG Xiaoli， ZHAO Caiyan， GAO Wenqiao

（ Department of Stomatology No.3， Hengshui Fifth People's Hospital， Hengshui 053000， Hebei， China ）

Abstract： Objective" To explore the effect of personalized titanium mesh combined with barrier membrane in guided bone regeneration （GBR） repair for patients with upper anterior teeth bone defects， and its impact on the Pink Esthetic Score （PES） score. Methods" A retrospective analysis was conducted on the data of 208 patients with alveolar bone defects in the upper anterior teeth selected by the author's hospital from December 2020 to May 2022. All patients underwent GBR surgery and were grouped into a barrier membrane group （103 cases） and a composite group （105 cases） based on the different membrane materials used during the surgery. The barrier membrane group used a barrier membrane during surgery， while the composite group used a personalized titanium mesh on the basis of the barrier membrane group. The width and height changes of the patient's alveolar bone were understood， the PES score was evaluated， and the occurrence of complications was observed. Results" On the day and 6 months after surgery， the width and height of alveolar bone in both groups were greater than before surgery （P＜0.05）， the width and height of alveolar bone in both groups decreased at 6 months after surgery compared to the day after surgery （P＜0.05）， while the width and height of alveolar bone in the composite group were greater than those in the barrier membrane group at 6 months after surgery （P＜0.05）. At 3 and 6 months after surgery， the PES score of both groups was lower than the day after surgery （P＜0.05）， the PES score of both groups at 6 months after surgery was lower than that at 3 months after surgery （P＜0.05）， the PES score of the composite group at 6 months after surgery was higher than that of the barrier membrane group （P＜0.05）. There was no statistically obvious difference in the incidence of complications between the composite group （3.81%） and the barrier membrane group （5.83%） （P＞0.05）. Conclusion" The use of personalized titanium mesh combined with barrier membrane in GBR surgery for patients with upper anterior tooth bone defects has a good repair effect on bone defects， is beneficial for improving gingival aesthetics， and has high safety.

Key words： personalized titanium mesh; barrier membrane; upper anterior tooth bone defect; guided bone regeneration

上前牙缺失為一種常見的口腔問題，通常由外傷、重度牙周病所致。牙缺失后咬合力失去對牙槽骨的功能性刺激，牙槽骨常因廢用性萎縮而出現缺損，繼而為后期人工牙根植入及植入早期穩定性的維持增加難度[1]。且上前牙的位置較為特殊，此處牙槽骨缺損可嚴重影響牙齦美觀度，故需重視骨缺損的修復。……