富含β-磷酸三钙的煅烧骨填充材料修复牙槽骨缺损的临床效果评价

发布时间：2018-03-24 03:23

  本文选题：骨缺损　切入点：骨填充材料　出处：《青岛大学》2017年硕士论文

【摘要】：目的:富含β-磷酸三钙(β-TCP)的骨填充材料与Bio-Oss骨填充材料做对比分析,评价富含β-磷酸三钙的骨填充材料的临床疗效和安全。方法:本研究选取在青岛大学附属医院就医的拔牙患者40例,所选患者为18-70岁之间,有前牙或者前磨牙疾患需要拔除,口腔卫生状况良好,无全身系统性疾病。经统一研究员对受试者对患者进行口腔专科检查和血液检查,筛选入组患者。本实验采取双盲实验方法。将患者随机分为试验组和对照组,试验组采用富含β-磷酸三钙的骨填充材料,对照组采用瑞士Geistlich公司的Bio-Oss骨填充材料。对经过筛检入组的患者进行患牙拔除术并在拔牙窝植入对应骨粉,拔牙窝双层明胶海绵覆盖,拉拢缝合牙龈,术后即刻拍CT记录牙槽嵴的高度和宽度以及CT值,观察两组骨填充材料的安全性:1周复诊拆线,观察黏膜愈合状况;拔牙创有无出现骨粉脱落,术后6个月复诊拍CT测量牙槽嵴的高度和宽度以及CT值。将拔牙后即刻CT与拔牙后六个月之间的CT数据进行比较,观察其有效性。计算出牙槽嵴垂直向骨吸收量和颊舌向骨吸收量。进一步分析试验组与对照组的统计学差异,观察试验组骨填充材料与对照组骨填充材料的有效性和安全性的差异。结果:1.口腔内临床检查40位受试者牙龈生长状况良好,试验组与对照组术后24小时大部分患者疼痛为Ⅰ级疼痛,疼痛程度不明显。试验组有2位患者出现II级疼痛,对照组患者有3位患者出现II级疼痛。试验组和对照组共40例患者拔牙创等级都为甲级愈合,未有乙级愈合或丙级愈合的患者。试验组和对照组患者拔牙创愈合时间大部分都在7天以内,大于7天的患者,实验组2人,对照组1人,受试者均未出现感染、过敏等严重不良反应,术后一周复诊均未出现术区感染,骨粉脱落等情况。实验组和对照组均未发生不良事件。术后六个月拔牙窝处牙槽骨丰满未有骨嵴骨棱出现。试验组与对照组安全性对比P0.052.CT观察及CT测量值。CT可见实验组和对照组患者的成骨效果均很好。试验组与对照组骨吸收的平均距离在水平方向在1.9mm左右,垂直方向在1mm左右。CT值在900-1000左右。术前术后试验组与对照组骨吸收量无明显差异P0.05,同一时间段试验组与对照组CT值均数相近,同一时间段两组数据比较P值0.05,试验组与对照组数据无统计学差异,但同组患者的术后6个月CT值高于术后即刻CT值,P0.05。试验组与对照组无明显差异。结论:在拔牙窝骨缺损中,将富含β-磷酸三钙骨填充材料与瑞士Geistlich公司的Bio-Oss骨填充材料对比,骨缺损区软硬组织生长状况及两者六个月的成骨效果和骨吸收量无明显差异。其疗效和安全性与瑞士Geistlich公司的Bio-Oss骨填充材料相当。
[Abstract]:Objective: to compare the 尾 -TCP-rich bone filling material with Bio-Oss bone filling material. To evaluate the clinical efficacy and safety of bone filling materials rich in 尾 -tricalcium phosphate. Methods: forty patients with extraction of teeth were selected from Qingdao University affiliated Hospital. The selected patients were between 18 and 70 years of age. The patients with anterior teeth or premolar diseases needed to be removed. The oral hygiene condition is good, there is no systemic disease of the whole body. The patients were randomly divided into two groups: the experimental group and the control group. The patients in the experimental group were filled with bone filled with 尾 -tricalcium phosphate (尾 -tricalcium phosphate). The patients in the control group were treated with Bio-Oss bone filling material from Geistlich Company of Switzerland. The patients in the screening group were treated with extraction of the affected teeth and the corresponding bone powder was implanted in the extraction nest. The double layer gelatin sponge was used to cover the extraction nest and the gingiva was closed and sutured. The height, width and CT value of alveolar ridge were recorded by CT immediately after operation. The safety of bone filling materials in the two groups was observed. The height and width of alveolar ridge and CT value were measured 6 months after operation. Ct data were compared between immediately after extraction and 6 months after extraction. The vertical bone resorption and buccal bone resorption of alveolar ridge were calculated. The statistical difference between the experimental group and the control group was further analyzed. The efficacy and safety of bone filling materials in the experimental group and the control group were observed. Results the gingival growth status of 40 subjects with clinical examination in oral cavity was good. 24 hours after operation, most of the patients in the trial group and the control group had pain of grade 鈪，

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