生物可吸收性胶原膜的固定方式对上颌前牙区水平骨增量效果的影响

doi:10.12337/zgkqzzxzz.2024.10.005

中国口腔种植学杂志 ›› 2024, Vol. 29 ›› Issue (5): 420-428.DOI: 10.12337/zgkqzzxzz.2024.10.005

生物可吸收性胶原膜的固定方式对上颌前牙区水平骨增量效果的影响

张硕^1,2, 刘畅¹, 肖含瑜¹, 张伟峰¹, 邓焕泽¹, 张健^1,2

¹天津市口腔医院种植科南开大学医学院 300041;
²天津市口腔功能重建重点实验室 300041

收稿日期:2024-07-15 出版日期:2024-10-30 发布日期:2024-10-30
通讯作者: 张健,Email：zhangstoma@hotmail.com,电话：022-59080599
作者简介:张硕,医师、博士,研究方向：口腔种植学;张健,医齿学博士、教授、主任医师、博士研究生导师、天津市口腔医院（南开大学口腔医院）副院长,研究方向：口腔种植学
基金资助:
天津市口腔功能重建重点实验室青年项目（2023KLQN01）; 天津市医学重点学科（专科）建设项目（TJYXZDXK-048A）

The influence of bioabsorbable collagen membrane fixation protocols on horizontal ridge augmentation in the maxillary anterior region

Zhang Shuo^1,2, Liu Chang¹, Xiao Hanyu¹, Zhang Weifeng¹, Deng Huanze¹, Zhang Jian^1,2

¹Department of Oral Implantology, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin 300041, China;
²Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin 300041, China

Received:2024-07-15 Online:2024-10-30 Published:2024-10-30
Contact: Zhang Jian, Email: zhangstoma@hotmail.com, Tel:0086-22-59080599
Supported by:
Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction Youth Project (2023KLQN01); Tianjin Key Medical Discipline (Specialty) Construction Project (TJYXZDXK-048A)

摘要/Abstract

摘要： 目的评估生物可吸收性胶原膜的不同固定方式对上颌前牙区引导骨再生（guided bone regeneration,GBR）获得的水平骨增量效果的影响。方法本回顾性研究共纳入36例患者,在上颌前牙区植入单颗种植体同期行GBR,根据术中生物可吸收性胶原膜的固定方式不同,分为3组：组1仅使用膜钉固定;组2仅使用可吸收缝线固定;组3联合使用膜钉及可吸收缝线固定。在术后即刻（T1）和骨愈合6个月后（T2）分别拍摄锥形束CT（cone beam computed tomography,CBCT）,测量距离种植体肩台0、2、4、6 mm（H₀、H₂、H₄、H₆）处的唇侧牙槽骨水平骨宽度,计算各组骨愈合期间的水平骨丧失量（mm）和丧失率（%）,记录术后并发症发生率。结果 6个月骨愈合后,各组在H₀~H₆均有明显骨丧失（P<0.05）;在H₂处,组1的水平骨丧失量和丧失率明显小于组2（P<0.05）;在H₀处,组3的水平骨丧失量和丧失率明显小于组1（P<0.05）;在H₀~H₄,组3的水平骨丧失量和丧失率明显小于组2（P<0.05）;各组创口红肿、创口出血、创口裂开和术后感染的发生率无差异（P>0.05）。结论在上颌前牙区种植同期行水平骨增量时,仅使用膜钉固定胶原膜较仅使用可吸收缝线在近种植体肩台处的骨增量效果更佳,联合使用膜钉和可吸收缝线比两者单独使用能获得更好的骨增量效果。

关键词: 引导骨再生, 上颌前牙区, 水平骨增量, 生物可吸收性胶原膜

Abstract: Objective To evaluate the influence of bioabsorbable collagen membrane fixation protocols on horizontal ridge augmentation in the maxillary anterior region. Methods A total of 36 patients were enrolled in this retrospective study. One implant was placed in the maxillary anterior region, and simultaneous guided bone regeneration (GBR) surgery was performed. Participants were divided into 3 groups based on different bioabsorbable collagen membrane fixation protocols. Group 1: fixation with titanium pins; Group 2: fixation with absorbable sutures; Group 3: fixation with titanium pins and absorbable sutures. Cone beam computed tomography (CBCT) was performed immediately after surgery (T1) and at six months post-surgery (T2), respectively. The horizontal bone width of the augmented region was analyzed at the implant shoulder (H₀) and 2, 4, 6 mm apical to the implant shoulder (H₂, H₄, H₆). Changes in labial bone width during bone healing were calculated as absolute values (mm) and relative values (%). The incidence of postoperative complications was recorded. Results After six months of bone healing, all groups showed significant bone loss at H₀-H₆ compared to immediate post-surgery results (P<0.05). At H₂, horizontal bone loss in Group 1 was significantly less than in Group 2 (P<0.05). Group 3 exhibited significantly less horizontal bone loss compared to Group 1 at H₀ (P<0.05), and Group 3 showed significantly less bone loss than Group 2 at H₀-H₄ (P<0.05). There were no significant differences in the incidence of hematoma, wound bleeding, wound dehiscence, or infection among the groups (P>0.05). Conclusion When implant placement with simultaneous horizontal ridge augmentation was performed in the maxillary anterior region, membrane fixation with titanium pins demonstrated superior results of the augmented region near the implant shoulder compared to fixation with absorbable sutures. However, the combined use of pins and absorbable sutures contributed to achieving better bone augmentation results compared to using either method alone.

Key words: Guided bone regeneration, Maxillary anterior region, Horizontal ridge augmentation, Bioabsorbable collagen membrane

张硕,刘畅,肖含瑜,等. 生物可吸收性胶原膜的固定方式对上颌前牙区水平骨增量效果的影响[J]. 中国口腔种植学杂志, 2024, 29(5): 420-428. DOI: 10.12337/zgkqzzxzz.2024.10.005

Zhang Shuo, Liu Chang, Xiao Hanyu, Zhang Weifeng, Deng Huanze, Zhang Jian. The influence of bioabsorbable collagen membrane fixation protocols on horizontal ridge augmentation in the maxillary anterior region[J].Chinese Journal of Oral Implantology, 2024, 29(5): 420-428.DOI: 10.12337/zgkqzzxzz.2024.10.005.

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生物可吸收性胶原膜的固定方式对上颌前牙区水平骨增量效果的影响

The influence of bioabsorbable collagen membrane fixation protocols on horizontal ridge augmentation in the maxillary anterior region

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