冷冻异体硬脑膜引导骨组织再生在口腔种植中的临床应用

采用异体硬脑经膜冷冻处理，作为引导种植体周围骨组织再生的膜材料，经临床２４例观察，未发生伤口愈合不良，形成瘘道等现象，所有病例种植体稳固，骨再生修复良好。其中１５例裂隙状骨缺损引导骨组织修复率达８７．８％。临床应用表明，冷冻异体硬脑膜引导骨组织再生，具有来源广，制备贮存简便，不产生排斥反应，引导骨组织生长效果好等特点，是目前较理想的引导骨组织再生膜材料，可广泛应用于各类与种植有关的骨缺损。     

冷冻异体硬脑膜引导骨组织再生的动物实验及在口腔种植中的临床应用研究

探索利用冷冻处理异体硬脑膜引导种植体周围骨组织再生的可能性。12只日本大耳白兔 ,在双侧下颌下缘造成骨缺损 ,右侧覆盖兔冷冻异体硬脑膜 ,左侧不覆膜 ;临床用于种植体周围骨缺损24例 ,采用人异体冷冻硬脑覆盖。结果实验动物伤口均I期愈合。组织学观察实验侧4周时骨表面有柱状骨突起 ,18周改建为成熟骨 ;对照侧明显慢于实验侧。临床患者骨修复良好 ,其中15例(16区)裂隙状骨缺损修复率达87.8 %。冷冻异体硬脑膜是一种较理想的引导骨组织再生膜材料     

冷冻异体骨膜引导即刻种植体周围骨缺损修复的临床研究

目的：观察机体对冷冻异体骨膜的反应及其引导骨组织再生的效果，方法：在实验研究成功的基础上，将冷冻异体骨膜作为引导组织再生膜性材料应用于引导即刻种植义齿植体周围骨缺损的修复。结果：临床观察证实机体对冷冻异体骨膜无排斥反应，膜无脱出，无感染，骨缺损修复率达到92．12％，结论：冷冻异体骨膜是一种理想的引导组织再生膜性材料。     

膜引导组织再生在口腔种植学中的应用研究

应用膜屏障阻止结缔组织和上皮组织细胞长入种植体区和骨缺损区,引导骨组织优先生长,增加种植体周围新骨形成,促进骨缺损的修复,这种手术即引导种植体周围骨组织再生术。本文对手术的方法,膜材料的性质,与种植体有关的骨缺损的分类及手术应用效果进行了讨论。     

膜引导组织再生在口腔种植学说中的应用研究

应用膜屏障阻止结缔组织和上皮组织细胞长入种植体区和骨缺损区，引导骨组织优先生长，增加种植体周围新骨形成，促进骨缺损的修复，这种手术即引导种植体周围同组织再生术。本文对手术的方法，膜材料的性质，与种植体有关的骨缺损的分类及手术应用效果进行了讨论。     

即刻种植术中应用可吸收性胶原膜的临床疗效观察

目的：探讨引导骨组织再生技术在即刻种植术中应用的临床疗效,为可吸收性胶原膜的临床应用提供依据。方法：将31枚种植体即刻植入18例患者的新鲜拔牙窝,可吸收性胶原膜覆盖于牙槽嵴顶封闭拔牙窝。术后当天、1周、1月、3月、6月及修复后每6个月行X线曲面断层片和临床检查,评价可吸收性胶原膜在即刻植入种植体周围缺损区引导骨组织再生修复的效果。结果：随访6～42个月,无一例发生膜暴露。18例31枚即刻植入种植体除1枚松脱外,其余种植体稳固无松动,种植体周围无炎症,未见明显骨吸收,未出现X线透射影,临床修复效果好,种植体存活率达96.8%。结论：可吸收性胶原膜生物相容性好,能促进骨缺损的再生修复,可成功地应用于即刻种植修复临床并获得满意效果。     

引导骨再生在种植体周骨缺损中的临床应用

目的：观察评估钛膜、Bio-oss骨粉引导种植体周围骨缺损骨组织再生的疗效。方法：选择种植区牙槽骨存在骨缺损的患者12例及即刻种植需引导骨再生的患者13例。植入种植体后，在骨缺损处植入自体骨与等量Bio-oss骨粉1:1，覆盖钛膜。术后1、2、3、4月进行X光检查及临床检查。二期手术时，取出钛膜，转移模型，进行金属烤瓷全冠修复或固定桥修复。半年后进行回访。结果：所有病历均未发现软组织瓣裂开、膜暴露、膜塌陷、膜移位及感染等并发症。只有1例因膜覆盖不够充分，新生骨组织量较少，其余病历骨缺损处均有大量骨组织生成，这些种植体都可作为修复基牙，可较好地恢复咀嚼功能。结论：钛膜、Bio-oss骨粉有良好的生物相容性，可以有效引导骨组织再生。     

Gore-Tex 膜引导骨再生技术在种植体周围炎治疗中的应用

目的：评价Ｇｏｒｅ－Ｔｅｘ膜引导骨再生技术治疗种植体周围炎的临床疗效。方法：对３例种植体周围炎患者局部冲洗和药物治疗控制感染后行翻刮治，应用Ｇｏｒｅ－Ｔｅｘ膜覆盖缺损，术后６月去除膜，摄Ｘ线片及进行临床评价。结果：３例骨缺损者均完全再生修复，种植体稳定。结论：局部冲洗和翻瓣刮治后，应用Ｇｏｒｅ－Ｔｅｘ膜覆盖骨缺损治疗种植体周围炎，可获得骨组织再生修复。     

钛膜引导骨再生在骨内种植体植入中的应用

目的：总结牙种植术后使用钛膜引导骨再生临床体会。方法：对30例47枚牙种植术中发现骨缺损、骨量不足的患者采用钛膜进行骨引导再生修复骨缺损及骨增量。术后定期观察，对新骨生长情况进行连续临床和X线的观察分析。结果：30例47枚牙种植术中，39枚种植体植入部位使用了钛膜。二期手术时种植体均已与骨组织形成理想的骨融合，顺利完成种植义齿修复。39枚种植体中有15枚种植体术后2个月的X线片可见到种植体封闭螺帽上方骨密度增高影。4月后二期手术切开牙龈时可见到新骨覆盖种植体表面，以骨凿等去除新骨后方可见到封闭螺帽。结论：医用钛膜在种植术中应用有较好的引导骨再生作用，有利于种植术后骨融合期新骨的形成。不可吸收性膜的一些固有缺陷可通过临床正确的设计关在术中严格按照操作要点进行手术，可获得理想的骨再生效果。     

骨诱导术在牙种植骨量不足病例的临床应用

目的:探讨应用诱导骨组织再生技术在种植牙时颌骨骨量不足的临床应用研究。方法:选择35例在种植手术时,种植体周围骨量不足的患者,采用可吸收胶原膜(Bio-Gide)和骨粉(Bio-Oss)行诱导骨组织再生,观察其促进颌骨再生和种植体骨整合的临床效果。结果:经6～18个月的临床观察和放射X线片检查,种植体周围骨缺损区骨组织再生情况良好,种植体稳定。结论:采用可吸收胶原膜(Bio-Gide)和骨粉(Bio-Oss)诱导再生技术用于种植牙术骨量不足的患者,可成功诱导骨组织再生、重建缺损的骨组织,促进种植体与新生骨组织形成良好的骨性结合。     

冷冻异体骨膜引导骨组织再生的实验研究

目的：探讨用冷冻异体骨膜作为引导骨组织再生膜的可能性；方法：取兔颅骨顶部骨膜经冷冻处理，在３１只日本大耳白兔的下颌骨造成两处骨缺失，采取同体对照，一处表面覆盖冷冻异体骨膜，另一处不覆盖。分别在第４、８、１２、１６周处死动物，行Ｘ线及组织学观察。结果：冷冻异体骨膜不产生排斥反应，可在体内维持８￣１２周，具有良好的阻挡纤维组织长入骨创面、分隔不同细胞及引导组织再生的功效。结论：冷冻异体骨膜是一种理想的     

引导骨组织再生技术应用于牙种植的临床观察

目的:临床观察引导骨组织再生技术在牙种植应用中的疗效。方法:对16例22枚牙种植区域的骨量不足及植入后的骨穿孔和骨缺损,采用人工骨、自体骨混合移植及生物胶原膜覆盖技术,促进和引导其骨形成从而完成牙种植术。结果:16例22枚牙种植体,全部成功,临床成功率为100%。结论:引导骨组织再生术的正确应用在牙种植方面是可靠而有效的。     

引导组织再生即刻种植术的临床研究

目的 :评价引导组织再生 (GTR)即刻种植术的临床效果 ,探讨影响其效果的临床因素。方法 :将 2 5颗种植立即植入 2 5位患者的新鲜拔牙窝 ,聚四氟乙烯 (PTFE)膜覆盖于牙槽嵴顶封闭拔牙窝 ,松驰唇颊侧粘骨膜瓣 ,严密缝合。术后当天、10天、1、2、3、4、5和 6个月拍X光片检查种植体周骨缺隙骨再生情况。术后 6个月拆除PTFE膜。完成修复后随访观察一年。结果 :无种植体松动或脱落 ;术后 2个月新生骨充满种植体周缺隙 ;术后 6个月新骨完全成熟 ,并与种植体紧密结合 ;膜早期暴露可导致种植体周牙槽嵴顶骨明显吸收。结论 :GTR即刻种植术能取得与延期种植相同的临床效果 ;膜的屏障作用最少应保持 2个月 ,术后 6个月是拆膜的最佳时间 ;膜早期暴露及其处理对GTR的效果有明显的影响     

Tissue regeneration in bone defects adjacent to endosseous implants: an experimental pilot study

Extraction socket defects or alveolar ridge defects may limit or restrict placement of implants. The present study assessed the efficacy of inducing bone formation with demineralized freeze-dried bone (DFDB), osteoinduction with hydroxyapatite (HA), and guided bone regeneration with expanded polytetrafluoroethylene (e-PTFE) in bone defects adjacent to endosseous implants in an animal model. Twenty-four implants were placed in the long bones of 3 pigs. After preparation of 24 cylindric acute defects adjacent to the coronal 5 mm of each implant, 18 of the defects were treated by DFDB, HA, or e-PTFE. The 6 remaining defects healed spontaneously with no treatment (controls). In each pig, one tibia received 4 commercially pure titanium screw implants (3.75 mm x 15 mm), while the contralateral tibia received 4 HA-coated cylindric implants (3.25 mm x 15 mm). Bone formation in response to the 3 treatments and control cases was evaluated using computer-assisted densitometric image analysis. The results showed that a higher density of tissue formed under e-PTFE membranes. A significantly greater increase in bone density was noticed in bone defects treated with an e-PTFE membrane vs DFDB (P = 0.04), in e-PTFE vs control sites (P = 0.04), and in defects treated with HA vs DFDB (P = 0.04) in HA-coated implants. In titanium implants the differences observed were not significant. It was also observed that bone regeneration in defects treated with HA differs with the type of implant used (titanium vs HA-coated implants), but such differences were not significant.     

引导组织再生在即刻种植上的应用研究

为了评价引导组织再生（ＧＴＲ）技术引导种植体周骨缺隙骨再生的效果，作者选择了２５例共２７颗不能保留的牙齿，于拔除后即刻种植，采用ＰＴＦＥ（聚四氟乙烯膜）覆盖于种植体和牙槽嵴顶上，游离龈瓣严密缝合，术后６个月将ＰＴＦＥ取出术中和术后６个月分别测量每个种植体周骨缺隙的最大深度，计算出最大充填高度和骨充填率，且分别于术后１０天，一个月，二个月，四个月和六个月拍Ｘ光片观察骨再生和种植体骨结合情况，结果表明     

膨体聚四氟乙烯膜在牙种植体周围骨缺损中的应用

目的：观察膨体聚四氟乙烯(e—PTFE)膜在牙种植体周围骨缺损中引导骨再生的作用。方法：25例患者植人65枚种植钉，其中32枚钉周围有骨缺损，分别作植骨覆盖膨体聚四氟乙烯膜或直接覆盖膨体聚四氟乙烯膜处理。术后观察有无感染，膜有无外露；二期手术时取出膜，观察骨再生效果。结果：25例患者覆盖聚四氟乙烯膜后，23例无明显炎症反应，2例术后感染严重，拔除种植钉；2例膜外露，经处理后伤口愈合；膜于术后3—6个月时取出，23例均取得了较好的骨再生效果。结论：国产聚四氟乙烯膜可应用于种植体周围骨缺损的引导骨再生。     

Effect of allogeneic freeze-dried demineralized bone matrix on regeneration of alveolar bone and periodontal attachment in dogs

Abstract. This split-mouth study was designed to evaluate regeneration of alveolar bone and periodontal attachment following implantation of allogeneic. freeze-dried, demineralized bone matrix (DBM). Buccal fenestration defects (6×4 mm) were created on the maxillary canine teeth in 6 beagle dogs. DBM was implanted into one randomly selected defect in each animal. The contralateral defect served as surgical control. Tissue blocks were harvested following a 4-week healing interval and prepared for histometric analysis. DBM was discernible in all implanted defects with limited evidence of bone metabolic activity. The DBM particles appeared invested within a dense connective tissue, often in close contact to the instrumented root. Fenestration defect height averaged 3.8±0.1 and 3.7±0.3mm, total bone regeneration 0.9±0.9 and 0.4±1.2 mm, and total cementum regeneration 2.3±1.5 and 0.6±0.7 mm for DBM and control defects, respectively. Differences with regards to cementum regeneration were statistically significant ( p =0.03). In summary, the results of this study suggest that DBM implants may enhance cementum regeneration in this defect model, and that they have no apparent effect on alveolar bone regeneration. Enhanced cementum regeneration may be possibly be explained by provisions for guided tissue regeneration from the implant suppressing a significant influence of the gingival connective tissue on the healing process. Moreover, a 4-week healing interval appears insufficient for turnover of DBM.     

Localized ridge augmentation using titanium micromesh

Guided bone regeneration (GBR) has been used recently for the regeneration of bone in conjunction with the placement of dental implants, for augmentation of resorbed alveolar crests, and to treat localized ridge deformities. Twenty-two patients with alveolar crest defects or peri-implant dehiscences participated in this study. Titanium implants were inserted, and the defects were covered with a titanium micromesh, above which was positioned an e-PTFE membrane. After healing, the 2 membranes were removed and a small specimen of the underlying tissues was retrieved with a small trephine. The postoperative healing was mostly uneventful, and only a few dehiscences with membrane exposure were observed. The space under the membranes was, in all patients, filled by a tissue with the macroscopic features of newly formed bone. No residual bone defects were observed and an increase of the alveolar width or height was observed. No untoward effects on bone regeneration were observed in the cases with membrane exposure. Histology showed that the underlying regenerated tissues were composed, in all cases, by newly formed bone. In conclusion, our results show that very satisfactory results concerning GBR techniques can be obtained even without the use of grafts under barrier membranes.