上颌磨牙位点保存两种创口封闭方式的临床效果比较

doi:10.12337/zgkqzzxzz.2024.02.009

中国口腔种植学杂志 ›› 2024, Vol. 29 ›› Issue (1): 49-55.DOI: 10.12337/zgkqzzxzz.2024.02.009

上颌磨牙位点保存两种创口封闭方式的临床效果比较

刘宗艺¹, 张清彬¹, 叶展超², 于长英¹, 刘婉清¹

¹福建医科大学附属厦门弘爱医院口腔科 361000;
²厦门大学附属中山医院口腔科 361004

收稿日期:2023-08-10 出版日期:2024-02-29 发布日期:2024-03-07
通讯作者: 刘宗艺,Email：liuzongyi77@163.com,电话：0592-5262330
作者简介:刘宗艺主治医师、硕士,研究方向：口腔外科及口腔种植学
基金资助:
2020年厦门市医疗卫生指导性项目（3502Z20209074）

Comparison of the clinical effects of two different wound closure methods in extraction site preservation of maxillary molars

Liu Zongyi¹, Zhang Qingbin¹, Ye Zhanchao², Yu Changying¹, Liu Wanqing¹

¹Department of Stomatology, Xiamen Humanity Hospital, Fujian Medical University, Xiamen 361000, China;
²Department of Stomatology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen 361004, China

Received:2023-08-10 Online:2024-02-29 Published:2024-03-07
Contact: Liu Zongyi, Email: liuzongyi77@163.com, Tel: 0086-592-5262330
Supported by:
2020 Xiamen Medical and Health Guiding Project（3502Z20209074）

摘要/Abstract

摘要： 目的研究浓缩生长因子（concentrated growth factor,CGF）和游离龈移植（free gingival graft,FGG）分别与Bio-Oss Collagen联合应用于上颌磨牙拔牙位点保存的临床效果。方法选取需要拔除上颌磨牙的患者30例,拔牙后填入Bio-Oss Collagen,随机分为两组,A组覆盖CGF封闭创口,B组使用FGG封闭创口,术后观察创面愈合情况,半年后测量颊侧角化龈宽度变化,拍摄CBCT测量牙槽骨和上颌窦底变化。结果术后1周和2周时,B组创面愈合率均高于A组（P<0.05）;术后6个月,A组和B组颊侧角化龈宽度分别减少了（0.79±0.16）mm和（0.35±0.18）mm（P<0.05）。两组术后即刻和术后6个月牙槽骨宽度变化差值、颊腭侧牙槽骨高度变化差值和上颌窦底高度变化差值均无显著性差异（P>0.05）。结论上颌磨牙拔除后,植入Bio-Oss Collagen联合CGF或FGG行拔牙位点保存均可有效减少牙槽骨吸收,两者术后牙槽骨和上颌窦底变化没有显著差异,B组术后创面愈合率和颊侧角化龈减少量优于A组。

关键词: 拔牙位点保存, 浓缩生长因子, 游离龈移植, 上颌磨牙

Abstract: Objective To assess the clinical effects of concentrated growth factor (CGF) and free gingival grafting (FGG) in combination with Bio-Oss Collagen in extraction site preservation after maxillary molar extraction. Methods Thirty patients were randomly divided into two groups. The tooth sockets were filled with Bio-Oss Collagen, and then the wounds were closed using either CGF or FGG. Postoperative wound healing and the width of keratinized gingival tissue were observed, while CBCT was used to evaluate the changes in the alveolar bone and maxillary sinus floor. Results Group B exhibited a higher rate of wound healing compared to group A (P<0.05). The width of keratinized gingival decreased by (0.79±0.16) mm in group A and (0.35±0.18) mm in group B, respectively (P<0.05). There was no significant difference between the two groups regarding changes in alveolar bone or maxillary sinus floor (P>0.05). Conclusion Both CGF and FGG combined with Bio-Oss Collagen effectively reduced bone resorption during ridge preservation after maxillary molar extraction, with no significant differences observed in alveolar bone or maxillary sinus floor changes between the two groups. However, FGG demonstrated better wound healing rates and less reduction of buccal keratinized gingival compared to CGF.

Key words: Extraction site preservation, Concentrated growth factor, Free gingival graft, Maxillary molar

刘宗艺,张清彬,叶展超,等. 上颌磨牙位点保存两种创口封闭方式的临床效果比较[J]. 中国口腔种植学杂志, 2024, 29(1): 49-55. DOI: 10.12337/zgkqzzxzz.2024.02.009

Liu Zongyi, Zhang Qingbin, Ye Zhanchao, Yu Changying, Liu Wanqing. Comparison of the clinical effects of two different wound closure methods in extraction site preservation of maxillary molars[J].Chinese Journal of Oral Implantology, 2024, 29(1): 49-55.DOI: 10.12337/zgkqzzxzz.2024.02.009.

参考文献

[1] Avila-Ortiz G, Chambrone L, Vignoletti F.Effect of alveolar ridge preservation interventions following tooth extraction: a systematic review and meta-analysis[J]. J Clin Periodontol, 2019,46(Suppl 21):195-223. DOI: 10.1111/jcpe.13057.
[2] 李芷萱, 冯立新, 徐颖, 等. 不同自体血小板浓缩物在重度牙周炎拔牙后位点保存中的应用[J].口腔颌面修复学杂志,2022,23(3):190-195. DOI: 10.19748/j.cn.kqxf.1009-3761.2022.3.005.
[3] 樊瑞鑫, 王雯. 拔牙位点保留后骨胶原联合自体软组织瓣植入对前牙拔牙后美学满意度的影响[J].中国美容医学, 2022, 31(1):129-132.DOI:10.15909/j.cnki.cn61-1347/r.004860.
[4] Singh KP, Prasad R, Chari PS, et al.Effect of growth hormone therapy in burn patients on conservative treatment[J]. Burns, 1998,24(8):733-738. DOI: 10.1016/s0305-4179(98)00113-2.
[5] Nagelschmidt M, Becker D, Bönninghoff N, et al.Effect of fibronectin therapy and fibronectin deficiency on wound healing: a study in rats[J]. J Trauma, 1987,27(11):1267-1271. DOI: 10.1097/00005373-198711000-00011.
[6] Chen YW, Finkelman M, Papaspirisdakos P, et al.Comparative analysis of dimensional alterations following extraction of maxillary molars using three-dimensional images' superimposition: a CBCT study[J]. Odontology, 2021,109(2):514-523. DOI: 10.1007/s10266-020-00568-y.
[7] Sharan A, Madjar D.Maxillary sinus pneumatization following extractions: a radiographic study[J]. Int J Oral Maxillofac Implants, 2008,23(1):48-56.
[8] Lombardi T, Bernardello F, Berton F, et al.Efficacy of alveolar ridge preservation after maxillary molar extraction in reducing crestal bone resorption and sinus pneumatization: a multicenter prospective case-control study[J]. Biomed Res Int, 2018,2018:9352130. DOI: 10.1155/2018/9352130.
[9] Nunes LS, Bornstein MM, Sendi P, et al.Anatomical characteristics and dimensions of edentulous sites in the posterior maxillae of patients referred for implant therapy[J]. Int J Periodontics Restorative Dent, 2013,33(3):337-345. DOI: 10.11607/prd.1475.
[10] Fok MR, Pelekos G, Tonetti MS.Feasibility and needs for simultaneous or staged bone augmentation to place prosthetically guided dental implants after extraction or exfoliation of first molars due to severe periodontitis[J]. J Clin Periodontol, 2020,47(10):1237-1247. DOI: 10.1111/jcpe.13344.
[11] Cha JK, Song YW, Park SH, et al.Alveolar ridge preservation in the posterior maxilla reduces vertical dimensional change: a randomized controlled clinical trial[J]. Clin Oral Implants Res, 2019,30(6):515-523. DOI: 10.1111/clr.13436.
[12] 皮雪敏, 刘倩, 陈德平, 等. 上颌窦底提升方案的决策原则(三)[J]. 中国口腔种植学杂志, 2023, 28(1):58-66.DOI: 10.12337/ zgkqzzxzz.2023.02.011.
[13] 罗纬, 陈向深, 蒋瑷, 等. 不同测量方法评估位点保存术后牙槽嵴高度变化[J].医学信息,2019,32(16):90-92. DOI: 10.3969/j.issn.1006-1959.2019.16.027.
[14] 赵丽萍, 詹雅琳, 胡文杰, 等. 不同测量方法评价磨牙拔牙位点保存术后牙槽骨的变化[J].北京大学学报(医学版), 2016,48(1):126-132. DOI: 10.3969/j.issn.1671-167X. 2016.01.023.
[15] 刘珍辉, 胡文杰. 拔牙位点保存创口封闭方式的临床进展[J]. 中国口腔种植学杂志, 2021, 26(5):322-327.DOI:10.12337/zgkqzzxzz.2021.10.010.
[16] 刘雨蒙, 袁长永. 浓缩生长因子软组织封闭功能在口腔种植中的应用[J]. 中国口腔种植学杂志, 2021, 26(6):396-399.DOI:10.12337/zgkqzzxzz.2021.12.011.
[17] Irinakis T, Tabesh M.Preserving the socket dimensions with bone grafting in single sites: an esthetic surgical approach when planning delayed implant placement[J].J Oral Implantol, 2007,33(3):156-163.DOI:10.1563/0.824.1.
[18] Tatakis DN, Promsudthi A, Wikesjö UM.Devices for periodontal regeneration[J]. Periodontol 2000,1999,19:59-73.DOI:10.1111/j.1600-0757.1999.tb00147.x.
[19] Landsberg CJ, Bichacho N. A modified surgical/prosthetic approach for optimal single implant supported crown. Part I-The socket seal surgery[J]. Pract Periodontics Aesthet Dent, 1994,6(2):11-17; quiz 19.
[20] Nobuto T, Imai H, Yamaoka A.Microvascularization of the free gingival autograft[J]. J Periodontol,1988,59(10):639-646.DOI:10.1902/jop.1988.59.10.639.
[21] 邱伟恩, 杨婷婷, 胡涵韬, 等. 三种材料封闭磨牙牙槽嵴保存术创的早期评价[J]. 中国美容医学, 2023, 32(05):137-142.DOI:10.15909/j.cnki.cn61-1347/r.005694.
[22] Jung RE, Siegenthaler DW, Hämmerle CH.Postextraction tissue management: a soft tissue punch technique[J]. Int J Periodontics Restorative Dent, 2004,24(6):545-553.DOI:10.1016/j.ijom.2004.08.005.
[23] Stimmelmayr M, Allen EP, Reichert TE, et al.Use of a combination epithelized-subepithelial connective tissue graft for closure and soft tissue augmentation of an extraction site following ridge preservation or implant placement: description of a technique[J]. Int J Periodontics Restorative Dent, 2010,30(4):375-381.
[24] 柳宏志, 邹高峰, 王天祥, 等. 浓缩生长因子促进犬软组织损伤修复的实验研究[J]. 口腔颌面外科杂志, 2013,23(1):28-31. DOI:10.3969/j.issn.1005-4979. 2013.01.006.
[25] Rodella LF, Favero G, Boninsegna R, et al.Growth factors, CD34 positive cells, and fibrin network analysis in concentrated growth factors fraction[J]. Microsc Res Tech, 2011,74(8):772-777. DOI: 10.1002/jemt.20968.
[26] 李佳, 何东宁. CGF在种植中促进成骨的研究探讨及应用进展[J]. 口腔颌面修复学杂志, 2021, 22(1):76-80.DOI:10.19748/j.cn.kqxf.1009-3761.2021.01.017.
[27] 李永斌,孙迎春,韦荣智,等.浓缩生长因子纤维蛋白与富血小板纤维蛋白体外降解的对比[J].中国组织工程研究, 2017,21(14):2234-2240.DOI:10.3969/j.issn. 2095-4344. 2017. 14.017.
[28] Stanca E, Calabriso N, Giannotti L, et al.Analysis of CGF biomolecules, structure and cell population: characterization of the stemness features of CGF cells and osteogenic potential[J]. Int J Mol Sci, 2021,22(16):8867.DOI: 10.3390/ ijms22168867.
[29] Botilde G, Colin PE, González-Martín O, et al.Hard and soft tissue analysis of alveolar ridge preservation in esthetic zone using deproteinized bovine bone mineral and a saddle connective tissue graft: a long-term prospective case series[J]. Clin Implant Dent Relat Res, 2020,22(3):387-396. DOI: 10.1111/cid.12899.

上颌磨牙位点保存两种创口封闭方式的临床效果比较

Comparison of the clinical effects of two different wound closure methods in extraction site preservation of maxillary molars

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