拔牙位点保存创口封闭方式的临床进展

doi:10.12337/zgkqzzxzz.2021.10.010

中国口腔种植学杂志 ›› 2021, Vol. 26 ›› Issue (5): 322-327.DOI: 10.12337/zgkqzzxzz.2021.10.010

拔牙位点保存创口封闭方式的临床进展

刘珍辉^1,2, 胡文杰¹

¹北京大学口腔医学院·口腔医院牙周科国家口腔医学中心国家口腔疾病临床医学研究中心口腔数字化医疗技术和材料国家工程实验室口腔数字医学北京市重点实验室,北京 100081;
²北京市崇文口腔医院牙周科 100062

收稿日期:2021-09-03 出版日期:2021-10-30 发布日期:2021-11-12
通讯作者: 胡文杰,Email: huwenjie@pkuss.bjmu.edu.cn,电话：010-62173402
作者简介:刘珍辉,口腔医学硕士、主治医师,研究方向：牙周病种植治疗;胡文杰,主任医师,教授,博士研究生导师,研究方向：牙周病多学科综合治疗和设计,牙周病种植治疗、微笑美学和前牙美学系列临床和相关基础研究、CBCT在牙周疾病诊断和治疗中的作用,牙周病和种植体周病与口腔微生物组学、免疫学和代谢组学研究
基金资助:
北京大学临床科学家计划专项（BMU2019LCKXJ010）; 北京市科学技术委员会首都临床特色应用研究基金(Z161100000516042); 首都卫生发展科研专项基金（2011-4025-04）

Advances of wound closure in alveolar ridge preservation

Liu Zhenhui^1,2, Hu Wenjie¹

¹Department of Periodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China;
²Department of Periodontology, Beijing Chongwen Stomatological Hospital, Beijing 100062, China

Received:2021-09-03 Online:2021-10-30 Published:2021-11-12
Contact: Hu Wenjie, Email: huwenjie@pkuss.bjmu.edu.cn, Tel: 0086-10-62173402
Supported by:
Peking University Clinical Scientist Program (BMU2019LCKXJ010); Capital Foundation for Clinical Characteristics and Application Research (Z161100000516042); The Capital Medical Development and Research Fund, PRC (2011-4025-04).

摘要/Abstract

摘要： 良好的软硬组织形态是实现成功种植治疗的基础。拔牙窝自然愈合过程中牙槽骨存在吸收和改建,最终有可能影响以修复为导向的种植治疗。实施拔牙位点保存可有效保存拔牙位点软硬组织轮廓,为种植修复创造条件。良好的创口封闭是保证该手术成功的重要环节之一。本文探讨了拔牙位点保存中不同创口封闭方式的特点,以期为临床上运用恰当的封闭方法达到最终良好效果提供理论参考。

关键词: 创口封闭, 拔牙位点保存, 重度牙周炎, 种植治疗

Abstract: Favorable soft and hard tissue morphology is the basis of successful implant therapy, following a tooth extraction, the alveolar ridge undergoes physiological remodeling which affects prosthetically driven implant restoration. Alveolar ridge preservation can effectively preserve the soft and hard tissue contour of tooth extraction sites and create conditions for implant restorations. Good wound closure is one of the important keys to ensure the success of the operation. This article discusses different methods of wound closure, in order to provide a reference for the clinical application of this technique to achieve ideal results.

Key words: Wound closure, Alveolar ridge preservation, Severe periodontitis, Implant therapy

刘珍辉,等胡文杰. 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

Liu Zhenhui, Hu Wenjie. Advances of wound closure in alveolar ridge preservation[J].Chinese Journal of Oral Implantology, 2021, 26(5): 322-327.DOI: 10.12337/zgkqzzxzz.2021.10.010.

参考文献

[1] 胡文杰. 牙槽嵴保存术的临床实施问题探讨[J].国际口腔医学杂志,2021, 48(3):249-258. DOI: 10.7518/gjkq.2021059.
[2] Araújo MG, Silva CO, Misawa M, et al. Alveolar socket healing: what can we learn?[M]. Periodontol2000. 2015. PMID: 25867983 Review.
[3] Tan WL, Wong TL, Wong MC, et al. A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans[J]. Clin Oral Implants Res, 2012,23 Suppl 5:1-21. DOI: 10.1111/j.1600-0501.2011.02375.x.
[4] Hämmerle CH, Araújo MG, Simion M. Evidence-based knowledge on the biology and treatment of extraction sockets[J]. Clin Oral Implants Res, 2012,23 Suppl 5:80-82. DOI: 10.1111/j.1600-0501.2011.02370.x.
[5] 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.
[6] Vignoletti F, Matesanz P, Rodrigo D, et al. Surgical protocols for ridge preservation after tooth extraction. A systematic review[J]. Clin Oral Implants Res, 2012,23 Suppl 5:22-38. DOI: 10.1111/j.1600-0501.2011.02331.x.
[7] Levi I, Halperin-Sternfeld M, Horwitz J, et al.Dimensional changes of the maxillary sinus following tooth extraction in the posterior maxilla with and without socket preservation[J]. Clin Implant Dent Relat Res, 2017,19(5):952-958. DOI: 10.1111/cid.12521.
[8] Lim G, Lin GH, Monje A, et al.Wound healing complications following guided bone regeneration for ridge augmentation: a systematic review and meta-analysis[J]. Int J Oral Maxillofac Implants, 2018,33(1):41-50. DOI: 10.11607/jomi.5581.
[9] 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.
[10] 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.
[11] 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.
[12] Karaca Ç, Er N, Gülşahı A, et al.Alveolar ridge preservation with a free gingival graft in the anterior maxilla: volumetric evaluation in a randomized clinical trial[J]. Int J Oral Maxillofac Surg, 2015,44(6):774-780. DOI: 10.1016/j.ijom.2015.01.015.
[13] Misch CE, Dietsh-Misch F, Misch CM. A modified socket seal surgery with composite graft approach[J]. J Oral Implantol, 1999,25(4):244-250. DOI: 10.1563/1548-1336(1999)025<0244:AMSSSW>2.3.CO;2.
[14] 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.
[15] 宿玉成. 口腔种植学[M].北京,人民卫生出版社, 2014.
[16] Mardinger O, Vered M, Chaushu G, et al.Histomorphometrical analysis following augmentation of infected extraction sites exhibiting severe bone loss and primarily closed by intrasocket reactive soft tissue[J]. Clin Implant Dent Relat Res, 2012,14(3):359-365. DOI: 10.1111/j.1708-8208.2010.00281.x.
[17] 林敏魁, 刘娟, 闫福华. 自身生长因子在重度牙周炎治疗中的应用进展[J].中国实用口腔科杂志,2016,9(4):209-213. DOI: 10.7504/kq.2016.04.005.
[18] 张荷馨, 李新月. 重度牙周炎拔牙后位点保存不同膜覆盖技术的疗效评价[J].口腔医学研究,2020,36(10):962-967. DOI: 10.13701/j.cnki.kqyxyj.2020.10.017.
[19] Lekovic V, Kenney EB, Weinlaender M, et al.A bone regenerative approach to alveolar ridge maintenance following tooth extraction. Report of 10 cases[J]. J Periodontol, 1997,68(6):563-570. DOI: 10.1902/jop.1997.68.6.563.
[20] Bartee BK. Extraction site reconstruction for alveolar ridge preservation. Part 2: membrane-assisted surgical technique[J]. J Oral Implantol, 2001,27(4):194-197. DOI: 10.1563/1548-1336(2001)027<0194:ESRFAR>2.3.CO;2.
[21] Wongpairojpanich J, Kijartorn P, Suwanprateeb J, et al.Effectiveness of bilayer porous polyethylene membrane for alveolar ridge preservation: a randomized controlled trial[J]. Clin Implant Dent Relat Res, 2021,23(1):73-85. DOI: 10.1111/cid.12965.
[22] Sclar AG.Preserving alveolar ridge anatomy following tooth removal in conjunction with immediate implant placement. The Bio-Col technique[J]. Atlas Oral Maxillofac Surg Clin North Am, 1999,7(2):39-59.
[23] Wood RA, Mealey BL.Histologic comparison of healing after tooth extraction with ridge preservation using mineralized versus demineralized freeze-dried bone allograft[J]. J Periodontol, 2012,83(3):329-336. DOI: 10.1902/jop.2011. 110270.
[24] Kim YK, Yun PY, Lee HJ, et al.Ridge preservation of the molar extraction socket using collagen sponge and xenogeneic bone grafts[J]. Implant Dent, 2011,20(4):267-272. DOI: 10.1097/ID.0b013e3182166afc.
[25] Spinato S, Galindo-Moreno P, Zaffe D, et al.Is socket healing conditioned by buccal plate thickness? A clinical and histologic study 4 months after mineralized human bone allografting[J]. Clin Oral Implants Res, 2014,25(2):e120-126. DOI: 10.1111/clr.12073.
[26] Natto ZS, Parashis A, Steffensen B, et al.Efficacy of collagen matrix seal and collagen sponge on ridge preservation in combination with bone allograft: A randomized controlled clinical trial[J]. J Clin Periodontol, 2017,44(6):649-659. DOI: 10.1111/jcpe.12722.
[27] Debel M, Toma S, Vandenberghe B, et al.Alveolar ridge dimensional changes after two socket sealing techniques. A pilot randomized clinical trial[J]. Clin Oral Investig, 2021,25(3):1235-1243. DOI: 10.1007/s00784-020-03428-9.
[28] Fotek PD, Neiva RF, Wang HL.Comparison of dermal matrix and polytetrafluoroethylene membrane for socket bone augmentation: a clinical and histologic study[J]. J Periodontol, 2009,80(5):776-785. DOI: 10.1902/jop.2009.080514.
[29] Schnutenhaus S, Doering I, Dreyhaupt J, et al.Alveolar ridge preservation with a collagen material: a randomized controlled trial[J]. J Periodontal Implant Sci, 2018,48(4):236-250. DOI: 10.5051/jpis.2018.48.4.236.
[30] Schnutenhaus S, Edelmann C, Dreyhaupt J, et al.Alveolar ridge preservation with a collagen cone: Histological, histochemical, and immunohistochemical results of a randomized controlled clinical trial[J]. Clin Exp Dent Res, 2020,6(3):345-355. DOI: 10.1002/cre2.279.
[31] Roman A, Cioban C, Stratul SI, et al.Ridge preservation using a new 3D collagen matrix: a preclinical study[J]. Clin Oral Investig, 2015,19(6):1527-1536. DOI: 10.1007/s00784-014-1368-1.
[32] Thoma DS, Villar CC, Cochran DL, et al.Tissue integration of collagen-based matrices: an experimental study in mice[J]. Clin Oral Implants Res, 2012,23(12):1333-1339. DOI: 10.1111/j.1600-0501.2011.02356.x.
[33] Bornstein MM, Bosshardt D, Buser D.Effect of two different bioabsorbable collagen membranes on guided bone regeneration: a comparative histomorphometric study in the dog mandible[J]. J Periodontol, 2007,78(10):1943-1953. DOI: 10.1902/jop.2007.070102.
[34] Al-Asfour A, Tengvall P, Andersson L, et al.Histologic analysis of a novel extracellular matrix membrane for guided bone regeneration: an experimental study in rabbits[J]. Int J Periodontics Restorative Dent, 2013,33(2):177-183. DOI: 10.11607/prd.1552.
[35] 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.
[36] Araújo MG, da Silva J, de Mendonça AF, et al. Ridge alterations following grafting of fresh extraction sockets in man. A randomized clinical trial[J]. Clin Oral Implants Res, 2015,26(4):407-412. DOI: 10.1111/clr.12366.
[37] López-Martínez F, Gómez Moreno G, Olivares-Ponce P, et al.Implants failures related to endodontic treatment. An observational retrospective study[J]. Clin Oral Implants Res, 2015,26(9):992-995. DOI: 10.1111/clr.12415.
[38] Zhao L, Xu T, Hu W, et al.Preservation and augmentation of molar extraction sites affected by severe bone defect due to advanced periodontitis: a prospective clinical trial[J]. Clin Implant Dent Relat Res, 2018,20(3):333-344. DOI: 10.1111/cid.12585.
[39] 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.
[40] 詹雅琳, 胡文杰, 甄敏, 等. 去蛋白牛骨基质与可吸收胶原膜的磨牙拔牙位点保存效果影像学评价[J].北京大学学报(医学版),2015,(1):19-26. DOI: 10.3969/j.issn.1671-167X.2015.01.004.
[41] 韦宁,徐涛,胡文杰,等.对伴上颌窦底骨缺损重度牙周病变磨牙实施微创拔牙及拔牙位点保存的初步探索(病例系列研究)[J].中国口腔种植学杂志,2021,26(2):96-101.DOI:10.12337/zgkqzzxzz.2021.04.004.
[42] 张浩筠, 危依萍, 胡文杰, 等. 重度牙周炎患者磨牙的两种拔牙位点保存术后种植修复6 年随访报告[J]. 中国口腔种植学杂志,2021, 26(1): 47-53. DOI: 10.12337/zgkqzzxzz.2021.02.011.
[43] 石宇彤,王翠,胡文杰,等.伴重度骨缺损的磨牙拔除后拔牙位点保存改善种植区软硬组织效果观察(附1 例2.5 年随访观察报告)[J].中国口腔种植学杂志,2021,26(3):178-184.DOI:10.12337/zgkqzzxzz.2021.06.007.
[44] 赵丽萍, 胡文杰, 徐涛, 等. 罹患重度牙周病变磨牙拔牙后两种牙槽嵴保存方法的比较[J].北京大学学报(医学版),2019,51(3):579-585. DOI: 10.19723/j.issn.1671-167X.2019.03.030.
[45] Zadeh HH, Abdelhamid A, Omran M, et al.An open randomized controlled clinical trial to evaluate ridge preservation and repair using SocketKAP(™) and SocketKAGE(™) : part 1-three-dimensional volumetric soft tissue analysis of study casts[J]. Clin Oral Implants Res, 2016,27(6):640-649. DOI: 10.1111/clr.12714.
[46] Bakhshalian N, Abdelhamid A, Park YJ, et al.Histological and histomorphometric response to socketkap™ and socketkage™ used for ridge preservation and repair: results from a randomized controlled clinical trial[J]. J Oral Maxillofac Surg, 2018,76(9):1884-1892. DOI: 10.1016/j.joms.2018.04.007.
[47] Wang R E, Lang N P. Ridge preservation after tooth extraction[J]. Clin Oral Implants Res, 2012,Suppl 6:147-156. DOI: 10.1111/j.1600-0501.2012. 02560.x.
[48] Barone A, Toti P, Piattelli A, et al.Extraction socket healing in humans after ridge preservation techniques: comparison between flapless and flapped procedures in a randomized clinical trial[J]. J Periodontol, 2014,85(1):14-23. DOI: 10.1902/jop.2013.120711.
[49] Fickl S, Zuhr O, Wachtel H, et al.Dimensional changes of the alveolar ridge contour after different socket preservation techniques[J]. J Clin Periodontol, 2008,35(10):906-913. DOI: 10.1111/j.1600-051X.2008.01305.x.
[50] Lee J, Lee JB, Koo KT, et al.Flap management in alveolar ridge preservation: a systematic review and meta-analysis[J]. Int J Oral Maxillofac Implants, 2018,33(3):613-621. DOI: 10.11607/jomi.6368.
[51] 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.
[52] Seibert JS.Reconstruction of deformed, partially edentulous ridges, using full thickness onlay grafts. Part I. Technique and wound healing[J]. Compend Contin Educ Dent, 1983,4(5):437-453.
[53] Sullivan HC, Atkins JH.Free autogenous gingival grafts. I. Principles of successful grafting[J]. Periodontics, 1968,6(3):121-129.
[54] Sullivan HC, Atkins JH.Free autogenous gingival grafts. 3. Utilization of grafts in the treatment of gingival recession[J]. Periodontics, 1968,6(4):152-160.
[55] López-Pacheco A, Soto-Peñaloza D, Gómez M, et al.Socket seal surgery techniques in the esthetic zone: a systematic review with meta-analysis and trial sequential analysis of randomized clinical trials[J]. Int J Implant Dent, 2021,7(1):13. DOI: 10.1186/s40729-021-00294-2.
[56] Meloni SM, Tallarico M, Lolli FM, et al.Postextraction socket preservation using epithelial connective tissue graft vs porcine collagen matrix. 1-year results of a randomised controlled trial[J]. Eur J Oral Implantol, 2015,8(1):39-48.
[57] Wei Y, Xu T, Hu W, et al.Socket Preservation following extraction of molars with severe periodontitis[J]. Int J Periodontics Restorative Dent, 2021,41(2):269-275. DOI: 10.11607/prd.4444.

拔牙位点保存创口封闭方式的临床进展

Advances of wound closure in alveolar ridge preservation

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 7

编辑推荐

Metrics

[1]	于久越, 贾雯昊, 方丽, 王健, 李江明, 刘晗, 郭启利. 利用Bio-Oss Collagen进行上颌磨牙拔除后拔牙位点保存的临床分析[J]. 中国口腔种植学杂志, 2023, 28(2): 90-96.
[2]	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.
[3]	石宇彤, 王翠, 胡文杰, 徐涛, 刘云松. 伴重度骨缺损的磨牙拔除后拔牙位点保存改善种植区软硬组织效果观察（附1例2.5年随访观察报告）[J]. 中国口腔种植学杂志, 2021, 26(3): 178-184.
[4]	韦宁, 徐涛, 胡文杰, 刘云松. 对伴上颌窦底骨缺损重度牙周病变磨牙实施微创拔牙及拔牙位点保存的初步探索（病例系列研究）[J]. 中国口腔种植学杂志, 2021, 26(2): 96-101.
[5]	邱立新. 拔牙窝植骨-拔牙位点保存技术要点[J]. 中国口腔种植学杂志, 2021, 26(1): 2-6.
[6]	戈怡, 姜秀瑛, 宿玉成. 上颌单颗中切牙拔牙位点保存后种植的长期美学效果分析[J]. 中国口腔种植学杂志, 2021, 26(1): 7-12.
[7]	刘焕磊. 拔牙位点保存技术应用于种植牙的临床研究分析[J]. 中国口腔种植学杂志, 2018, 23(4): 187-189.