血浆基质骨块用于牙槽嵴水平向骨增量的疗效观察

通过回顾系列病例性评估血浆基质骨块在牙槽嵴水平向骨增量中的应用效果。纳入2021年1月至2022年4月于武汉大众口腔医院种植科行牙槽嵴水平向骨增量的患者资料共25例, 采用自体骨屑、脱蛋白牛骨基质和血浆基质制作血浆基质骨块, 结合可吸收胶原膜和血浆基质膜进行引导性骨再生术。术前及术后6个月对患者锥形束CT数据进行三维重建, 测量距牙槽嵴顶2及8 mm处骨宽度及牙槽骨体积。采用配对t检验比较相同测量项目两时间点间差异。结果显示, 与术前[(5.5±3.4)mm]相比, 术后6个月距牙槽嵴顶2 mm处骨宽度[(9.5±2.5)mm]显著增加(t=3.40, P<0.001);距牙槽嵴顶8 mm处骨宽度术前与术后6个月差异无统计学意义(t=3.13, P=0.050)。对于牙槽骨体积, 术前距牙槽嵴顶2和8 mm处牙槽骨体积分别为(5 114±3 883)和(3 329±2 874)mm3, 术后6个月后分别显著增加至(5 999±4 318)和(4 042±3 260)mm3(t=5.69, P<0.001;t=5.69, P<0.001)。证实在引导性骨再生术中采用血浆...     

骨劈开、牙槽嵴扩张联合GBR技术同期上颌前牙区种植的临床疗效观察

目的:评价上前牙区牙槽骨水平宽度不足的患者应用骨劈开、牙槽嵴扩张联合GBR技术同期植入种植体的的临床疗效。方法:2011年5月~2013年9月,选取来本院就诊的24例上前牙种植区剩余骨量不足患者,应用超声骨刀行前牙牙槽骨劈开术,骨扩张、同期植入30枚Ankylos种植体,辅以GBR技术。6个月后,平行投照根尖片、CBCT复查,完成修复,随访1年。结果:牙槽嵴唇腭侧术前、术后平均宽度分别为(3.2±0.12)mm和(6.4±0.16)mm,差异有统计意义(t=239.024,P<0.05),牙槽骨宽度在术后基线与半年后结果相比,差异无统计意义(t=1.795,P>0.05)。结论:骨劈开、牙槽嵴扩张联合GBR技术并同期植入种植体短期临床效果较好,远期效果有待于进一步观察。     

帐篷螺丝技术在下前牙区同期种植时水平骨增量的临床评价

目的：评价帐篷螺丝技术在下前牙区同期种植时水平向骨增量的临床应用效果。方法：18例下颌前牙区有较严重的水平向骨缺损时使用帐篷螺丝技术进行水平向骨增量,同期植入骨水平植体,植入术后6个月行二期手术,1月后进行上部修复,1年复诊。CBCT测量术前及术后6个月、修复后1年牙槽嵴宽度。采用单因素重复测量方差分析对所获数据进行统计分析。结果：18例患者38个种植位点,均获得较满意的骨增量效果。术前及术后6个月、修复后1年牙槽嵴宽度分别为(3.54±0.11)、6.82±0.08)和(6.17±0.07)mm,统计分析显示术后6月牙槽嵴宽度较术前明显增加(P<0.05)。与术后6个月相比,修复后一年牙槽嵴宽度减小(P<0.05)。结论：下前牙区种植体植入伴严重水平向骨缺损时,行帐篷螺丝骨增量技术可获得较好的骨增量效果。     

改良式骨劈开术水平骨增量对软硬组织的影响

目的:探讨改良式骨劈开术对上下颌骨软硬组织的影响。方法:40例上下颌部分牙列缺失,且残余牙槽嵴宽度窄于4 mm的患者,选自南方医科大学口腔医院种植中心。术前行锥型束计算机断层扫描(CBCT)以评估上下颌后部无牙区牙槽嵴的宽度,并测量该区域角化牙龈的宽度。所有患者均采用改良式骨劈开术进行水平骨增量。用SPSS16.0软件分析不同治疗过程中牙槽嵴宽度和角化牙龈宽度的数据。结果:在术前、术后即刻和术后3月,患者牙槽嵴宽度分别为(2.96±0.66) mm、(6.51±0.70) mm和(6.05±0.57) mm。术后即刻较术前有明显增宽(t=55.148,P<0.001),术后3个月后较术后即刻略有降低(t=-9.190,P<0.001),但仍大于术前(t=43.799,P<0.001)。角化牙龈宽度在术前和术后3个月后分别为(2.44±0.93) mm和(5.60±0.86) mm,术后3个月后高于术前(t=21.752,P<0.001)。结论:该改良式骨劈开术能应用于上下颌的水平向骨增量,软组织和硬组织的宽度均能得到有效提高。     

牙槽嵴扩张技术在上颌牙种植中的临床应用

目的　评价牙槽嵴扩张技术在上颌牙种植中的应用效果。方法　对49例牙槽嵴骨量不足的上颌牙种植采用骨扩张器Condenser进行牙槽嵴扩张。根椐不同的缺牙位置,植入与天然牙根直径相当的种植体,以满足患者功能与美学的需要。结果　在49例患者牙槽嵴骨量不足的缺牙区,植入了86枚种植体。术前患者上颌前牙区牙槽嵴宽度平均为3~5·1 mm,术后牙槽嵴宽度平均增加3·3~5·4 mm;术前上颌后牙区,牙槽骨高度平均为6~ 10 mm,术后牙槽骨高度平均增加2~7 mm;种植体均获得初始稳定性;术后6月,X线片显示种植体与牙槽骨形成了紧密的骨性结合骨,种植体植入6个月后进行2期修复。结论　ERE技术适用于上颌牙槽骨扩张,可达到功能与美学的要求,方法简单,值得临床推广。     

骨片移植技术与引导性骨再生技术的牙槽嵴水平骨增量效果及患者疼痛度比较

目的：比较以生物学为导向的骨增量技术中骨片移植技术（BBA）和引导性骨再生技术（GBR）在刀刃状牙槽嵴骨增量中的临床效果及患者术中术后的疼痛VAS视觉量表。方法：收集2020年1月至2022年12月50例需通过植骨后行种植牙修复的刀刃状牙槽嵴患者，由同一位经验丰富的外科医生连续进行了50次手术，其中23例采用BBA手术（BBA组），27例采用GBR手术（GBR组）。在CBCT图像上进行测量水平牙槽骨宽度，对比手术前以及手术后半年的牙槽骨宽度，计算水平骨增量的变化。同时对患者术前和术后进行疼痛VAS视觉量表分析。结果：BBA组及GBR组对术前、术后6月的牙槽骨宽度行配对样本t检验，BBA组牙槽骨宽度增加明显大于GBR组（P<0.05）。对BBA组及GBR组的水平骨增量行独立样本t检验，BBA组水平骨增量明显大于GBR组（P<0.05）。对BBA组及GBR组的VAS疼痛视觉量表评分行独立样本t检验分析，BBA组患者术中、术后2小时、术后7天的疼痛度高于GBR组（P<0.05），两组患者术后1天及术后3天疼痛相同（P>0.05）。结论：虽然采用BBA技术的种植牙患者在...     

采用胶原膜固定法引导骨再生技术行牙槽嵴水平增量的临床试验研究

目的 测量分析水平向中重度牙槽骨缺损患者行引导骨组织再生术前术后的硬组织变化。方法 采用可吸收膜与膜钉结合使用的方法,同时使用小牛骨粉+自体骨(约各占50%)的植骨方式进行引导骨再生手术,术前及术后CBCT(cone beam computed tomography)数据经三维重建后拟合,测量引导骨组织再生术前术后距牙槽嵴顶2 mm及8 mm处骨宽度及牙槽骨体积的变化,结果用配对t检验进行统计学分析。结果 引导骨组织再生术后距牙槽嵴顶2 mm处骨宽度从（5.59±3.82）mm增加至（11.75±4.65）mm,8 mm处骨宽度从（7.72±3.32）mm增加至（13.58±4.26）mm,骨宽度增量差异具有统计学意义（P<0.01）。体积变化差异也具有统计学意义（P<0.01）。结论 可吸收膜与膜钉结合使用,同时使用小牛骨粉+自体骨（约各占50%）的植骨方式,对于牙槽嵴水平向中重度牙槽骨缺损有良好的增量效果。     

下前牙骨皮质切开术联合骨增量手术对唇侧骨增量的疗效评价

目的 评价下前牙骨皮质切开术联合骨增量手术对唇侧牙槽骨增量的效果.方法 回顾下前牙行骨皮质切开术联合骨增量手术患者术前、术后3个月和术后1年的锥形束CT(cone-beam computed tomography,CBCT),测量牙根长度、釉牙骨质界(cemento-enamel junction,CEJ)到牙槽嵴顶的距离以及距离CEJ 7 mm和9 mm处唇侧牙槽骨厚度,比较三个时间点各项指标的差异.结果 该手术对牙根长度无显著影响(P>0.05);与术前相比,术后3个月和术后1年牙槽嵴顶到CEJ的距离显著减少(P<0.05);术后1年牙槽嵴顶到CEJ的距离较术后3个月明显增加(P<0.05);总体与术前相比,术后3个月和术后1年距离CEJ 7 mm和9 mm处唇侧牙槽骨的厚度均显著增加(P<0.05).结论 骨皮质切开术联合骨增量手术对下前牙唇侧牙槽骨厚度的增加具有显著效果,对于下前牙正畸治疗有重要的临床意义.     

下前牙骨皮质切开术联合骨增量手术对唇侧骨增量的疗效评价

目的 评价下前牙骨皮质切开术联合骨增量手术对唇侧牙槽骨增量的效果.方法 回顾下前牙行骨皮质切开术联合骨增量手术患者术前、术后3个月和术后1年的锥形束CT(cone-beam computed tomography,CBCT),测量牙根长度、釉牙骨质界(cemento-enamel junction,CEJ)到牙槽嵴顶的距离以及距离CEJ 7 mm和9 mm处唇侧牙槽骨厚度,比较三个时间点各项指标的差异.结果 该手术对牙根长度无显著影响(P>0.05);与术前相比,术后3个月和术后1年牙槽嵴顶到CEJ的距离显著减少(P<0.05);术后1年牙槽嵴顶到CEJ的距离较术后3个月明显增加(P<0.05);总体与术前相比,术后3个月和术后1年距离CEJ 7 mm和9 mm处唇侧牙槽骨的厚度均显著增加(P<0.05).结论 骨皮质切开术联合骨增量手术对下前牙唇侧牙槽骨厚度的增加具有显著效果,对于下前牙正畸治疗有重要的临床意义.     

自体块状骨结合引导骨再生技术重建前牙区骨量不足的临床研究

目的：比较自体块状骨结合引导骨再生(GBR)技术重建前牙区骨量不足术后种植位点和非种植位点骨量变化的差异。方法：2010年12月—2011年8月间,术前全景片及CT评估14例患者(73个缺牙位点)前牙区骨量不足,于颏部或下颌支处取自体块状骨结合GBR技术重建前牙牙槽骨,并延期行种植体植入术(共植入42颗种植体)。术后即刻、3、6、9个月和最长随访时间点(平均13.8个月)行CT检查。利用Simplant 11.04软件三维重建并测量牙槽嵴顶骨宽度(alveolar crestal bone width, ACBW)、牙槽骨中部骨宽度(alveolar midway bone width, AMBW)和牙槽骨高度(alveolar bone height, ABH)。测量的所有数据按照种植位点(即种植体植入的位点)和非种植位点(即未植入种植体,后期利用桥体修复的位点)分为2组。采用SAS 9.0软件包对该2组数据进行配对t检验。结果：14例患者均顺利完成植骨和种植体植入手术,术后无头晕、头痛等不适,切口均愈合良好,42颗种植体在愈合和随访期内骨结合良好。术后2组骨改建评价显示：对种植位点的ACBW和AMBW,术后即刻骨增量和术后3个月骨吸收量有显著差异(P<0.05),而对ABH术后即刻骨增量,术后3、6个月骨吸收量有显著差异(P<0.05),其他时间段则无显著差异(P>0.05);对非种植位点的ACBW和ABH,术后即刻骨增量,术后3、6和9个月骨吸收量有显著差异(P<0.05),而对AMBW术后即刻骨增量,术后3、6个月骨吸收量有显著差异(P<0.05),其他时间段则无显著差异(P>0.05)。术后2组中ACBW、AMBW和ABH的骨量变化显示：术后即刻骨增量,术后3、6个月骨吸收量无显著差异(P>0.05);术后9个月和最长随访时间点骨吸收量存在显著差异(P<0.05)。结论：非种植位点较种植位点在种植体植入后发生更多的骨吸收,其原因是二期种植体植入手术产生的创伤和种植体能保存骨量两者相互作用所致。因此,即刻或同期植入种植体,避免二次手术,对骨量保存具有重要意义。     

Onlay植骨技术在上颌前牙美学区种植修复中的应用

目的:评估Onlay植骨技术在上颌前牙美学区种植修复中的应用。方法:随机选取82例行种植修复术的患者,根据术前评估,给予患者合理的Onlay植骨技术及牙种植修复手术方案。观察患者植骨期间牙槽嵴骨量变化及美学指标变化情况,记录牙种植体存活率。结果:Onlay植骨术后3个月末牙槽嵴水平向骨量(7.84±0.42)mm、牙槽嵴垂直向骨量(11.65±0.85)mm和术后6个月末牙槽嵴水平向骨量(7.15±0.60)mm、牙槽嵴垂直向骨量(10.86±0.63)mm均显著高于植骨前骨量,P=0.035、0.039、0.035、0.040;牙种植修复术后3个月末PES(7.48±1.36)分、WES(7.56±1.09)分和术后6个月末PES(7.78±1.42)分、WES(7.82±1.51)分均显著高于术前评分水平,P=0.040、0.043、0.038、0.032;Onlay植骨术后,骨组织美观丰满,伤口愈合良好,未出现植骨坏死,种植体存活率高。结论:将Onlay植骨技术应用于上颌前牙美学区种植修复中,可显著改善种植区骨量不足的问题,骨愈合情况良好,种植体存活率高,值得推广使用。     

Alveolar ridge augmentation with a prototype trilayer membrane and various bone grafts: a histomorphometric study in baboons

Barrier membranes have become a standard treatment option in alveolar ridge augmentation prior to implant placement. However, non-resorbable membranes require secondary surgery and resorbable membranes show an unfavorable degradation profile. The purpose of this study was to evaluate the potential of a slowly biodegradable/bioresorbable prototype trilayer membrane (PTLM) for supporting bone regeneration in alveolar ridge augmentation. Clinically relevant cavities were made 3 months after the extraction of the first and second molars in each jaw of six baboons. Each animal was treated with four different regimens: (1) autogenous bone block (ABB) alone, (2) ABB+PTLM, (3) deproteinized bovine bone mineral (DBBM)+PTLM and (4) no treatment. After 9 months, the baboons were sacrificed and block sections of the augmented area were subjected to histologic and histomorphometric analyses. Newly formed bone areas were determined at a distance of 1, 3, 7 and 10 mm from crestal. The data showed a well-preserved ridge profile at the membrane-protected sites, whereas non-protected bone blocks and control sites underwent severe resorption resulting in knife-edge ridge profiles. Significant differences were found between ABB+PTLM and ABB (P=0.0137-0.0232). DBBM+PTLM also produced a larger bone area compared with ABB alone (P=0.0396-0.0439). No significant difference in bone area was detectable between ABB+PTLM and DBBM+PTLM (P>0.05). The present study supports the use of the slowly biodegradable/bioresorbable PTLM with autografts and DBBM for lateral ridge augmentation in this type of bone defects.     

预成型钛网联合浓缩生长因子膜修复31例前牙种植区骨量不足的疗效分析

目的: 探讨预成型钛网联合浓缩生长因子（CGF）膜修复前牙种植区骨量不足的疗效。方法: 选择2017年1月—2020年2月就诊的前牙区骨量不足患者62例,依照电脑数字表法将其分为实验组（31例）与对照组（31例）。2组均采用种植修复,对照组种植后将预成型钛网覆盖于骨缺损区,实验组种植后将预成型钛网与CGF膜覆盖于骨缺损区。随访12个月,统计2组种植成功率,比较2组牙槽嵴高度、骨增量、牙槽骨骨密度、骨厚度、红色美学指数（PES）以及术后6个月内并发症发生情况。采用SPSS 19.0软件包进行统计学分析。结果: 随访12个月,2组种植成功率均为100%,无种植体松动、脱落等现象。2组术前牙槽嵴高度相比差异无统计学意义（P>0.05）,实验组术后牙槽嵴提升高度、骨增量显著高于对照组（P<0.05）。2组术前牙槽骨骨密度与骨厚度相比差异无统计学意义（P>0.05）,术后6个月、12个月的牙槽骨骨密度与骨厚度均显著低于术前（P<0.05）,术后6个月的牙槽骨骨密度均显著低于术后12个月（P<0.05）,术后6个月牙槽骨骨厚度均显著高于术后12个月（P<0.05）,且实验组术后6个月、12个月的牙槽骨骨密度与骨厚度均显著高于对照组（P<0.05）。实验组术后PES评分显著高于对照组（P<0.05）。术后6个月,2组并发症发生率相比无统计学差异（P>0.05）。结论: 预成型钛网联合CGF膜用于前牙区骨量不足患者种植修复,疗效确切,可提升种植修复的美容效果,改善术后骨代谢,安全可靠。     

去膜化GBR技术在后牙种植中的应用

目的: 探讨植骨后未覆盖屏障膜技术对后牙区种植体颊侧较小骨缺损的临床效果。方法: 选取2017年2月—2018年7月青岛大学附属医院口腔种植中心行后牙区种植手术的患者60例,所有患者种植体未暴露且颊侧至邻牙牙槽嵴顶弧线距离>1 mm。将患者随机分为单纯植骨无生物膜组（骨粉组,30例）和植骨并覆盖生物膜组（GBR组,30例）。分别于术后即刻及术后6个月通过锥形束CT（CBCT）测量种植体肩台下0、3、6 mm处（分别设为T1、T2、T3）颊侧牙槽嵴水平骨量变化。采用SPSS 22.0软件包对两组患者的牙槽嵴水平骨量变化、种植体周围软组织评价和患者满意度进行比较。结果: 术后6个月较术后即刻各位点牙槽嵴水平骨量变化为骨粉组：T1（-0.48±0.73）mm、T2（-0.64±0.95）mm、T3（-0.28±0.80）mm,GBR组：T1（-0.35±0.66）mm、T2（-0.49±0.74）mm、T3（-0.30±0.84）mm。2组各位点的牙槽嵴水平骨量变化无显著差异（P>0.05）。术后6个月复查, 2组种植体周围软组织均健康且无显著差异（P>0.05）。患者均有较高的满意度。结论: 后牙区种植体颊侧较小骨缺损可通过单纯植骨达到与GBR术相同的临床效果,能获得健康稳定的软组织以及较高的满意度。     

Clinical study of horizontal alveolar distraction with modified micro bone screws and subsequent implant placement

The aim of this study was to evaluate the clinical relevance of horizontal distraction osteogenesis (DO) with bone micro screws for reconstructing knife-edge alveolar crests before implant placement. Horizontal DO was performed in upper and lower alveolar crests of seven patients with resorption class IV according to Cawood and Howell. After osteotomy and a 1-week latency period, micro bone screws were reset daily for horizontal expansions by 0.5 mm. Dental implants were placed in the distracted area following a consolidation period of 12 weeks. Computer tomography was performed before DO and implant placement. Morphometric analysis showed a mean gain of 34.01 mm(2) (95% confidence interval [CI]: 10.55-57.48) in bone area and of 3.06 mm (95% CI: 1.81-4.31) in horizontal width, i.e. the horizontal dimension of the alveolus was approximately doubled within the first 5 mm of height. All 12 implants placed into the distracted area fulfilled the success criteria of stable osseointegration after 1 year of functional loading according to Albrektsson and colleagues. Despite the limited number of patients treated, data from the clinical study of horizontal DO with bone micro screws suggest that the generation of sufficient hard tissue in previously knife-edge alveolar crests for subsequent implant placement was possible.     

Clinical efficacy of autogenous dentin grafts with guided bone regeneration for horizontal ridge augmentation: a prospective observational study

The aim of this study was to evaluate the efficacy of autogenous dentin grafts with guided bone regeneration (GBR) for horizontal ridge augmentation. Nineteen patients with dentition and bone defects in whom tooth/teeth extraction was indicated were recruited. Autogenous teeth were prepared, fixed on the buccal sides of the defects, and covered with bone powder and resorbable membranes before implantation. The horizontal bone mass at 0 mm (W1), 3 mm (W2), and 6 mm (W3) from the alveolar crest was recorded using cone beam computed tomography, before, immediately after, and 6 months after dentin grafting. All adverse effects were recorded. The implant stability quotient (ISQ) was measured 6 months after implantation. Twenty-eight implants were placed 6 months after dentin grafting. At this time point, the bone mass was 4.72 ± 0.72 mm (W1), 7.35 ± 1.57 mm (W2), and 8.96 ± 2.38 mm (W3), which was significantly different from that before the surgery (P < 0.05). The bone gain was 2.50 ± 0.72 mm (W1), 4.10 ± 1.42 mm (W2), and 4.56 ± 2.09 mm (W3). No soft tissue dehiscence or infection was observed. Overall, 26.3% of the patients experienced severe pain after dentin grafting. The ISQ was 78.31 ± 6.64 at 6 months after implantation. Autogenous tooth roots with GBR might be effective for horizontal ridge augmentation. This technique could be an alternative to augmentation using autogenous bone grafts.     

Alveolar ridge reconstruction and/or preservation using root form bioglass cones

Abstract. Extraction of a tooth necessitated by factors such as developmental problems, trauma, severe periodontal disease and endodontic problems often causes deformities of the residual alveolar ridge in the maxillary anterior region. These cases are usually difficult to restore prosthetically and they result in poor esthetics and insufficient occlusal function. This study investigated the efficacy of root form bioactive glass cones implanted into (a) artificial sockets produced by bone splitting of previous extraction sites (group BS) and (b) fresh extraction sockets (group FES), We included conventional extraction sockets sutured without implanting the root form bioactive glass cones as a control (group C). A total of 16 patients were treated for whom extractions had been indicated due to severe periodontitis, 6 patients with 7 implant sites having Class II or III alveolar ridge deformities comprised the BS group. 5 patients with 10 implant sites comprised the FES group. Group C, comprised 5 patients with 10 extraction sites. Alveolar ridge width and height measurements were obtained using study casts preoperatively, immediately postoperatively. and at 3 and 12 months after operation. In the BS group, while the width of the alveolar ridge increased by 2.8 ± 1.18mm immediately after ridge augmentation procedure and by 2.4±0.93 mm at 1 year after operation (p<0.01), the height of the alveolar ridge increased by 1.8±1.99 mm and 1.4±1.74 mm respectively (p<0.05). In the FES group, the differences between preoperative original ridge height and width and postoperative measurements were not statistically significant, which demonstrated the efficiency of this method in preserving the alveolar ridge. In group C, while alveolar ridge width after 12 months had not Significantly changed, alveolar ridge height decreased significantly (1.35±1.05 mm. p<0.01). After 12 months, no dehiscences were detected and the differences in height between the groups remained significant. The results of this study indicate that this procedure is efficient in reconstructing alveolar ridges deformed as a result of extraction, particularly relevant in relation to preparation for subsequent restorative treatment.     

垂直骨劈开法的临床应用效果观察

目的 :探讨临床种植手术中针对牙槽脊水平宽度不足的病例应用垂直骨劈开法的治疗效果。方法 :选择25例种植患者 (均有水平牙槽脊宽度不足 )接受垂直骨劈开法进行种植治疗 ,应用stoma薄骨凿将齿槽脊垂直纵向劈开 ,获得充足植体区宽度 (5～7mm)观察术后4月软硬组织变化及种植体成活指标。结果 :25例患者接受牙槽脊垂直劈开法术式共植入31颗Frialit-2种植体 ,直径为3.4mm至4.5mm。术后4月 ,二期基台接入手术后因骨结合不佳丢失 φ3.8mmFrialit-2植体壹枚。成活率为97%。结论 :在水平牙槽脊宽度不足的病例中通过垂直纵向劈开的办法使牙槽脊的术前平均宽度由2.9±0.3mm达到术后平均宽度5.7±0.4mm。这种办法使种植手术相对适应症加宽 ,并获得良好的种植体初期稳定性 ,具有临床推广价值。     

Ridge Preservation With Acellular Dermal Matrix and Anorganic Bone Matrix Cell‐Binding Peptide P‐15 After Tooth Extraction in Humans

Background: Preventing ridge collapse with the extraction of maxillary anterior teeth is vital to an esthetic restorative result. Several regenerative techniques are available and are used for socket preservation. The aim of this study is to analyze by clinical parameters the use of acellular dermal matrix (ADM) and anorganic bovine bone matrix (ABM) with synthetic cell‐binding peptide P‐15 to preserve alveolar bone after tooth extraction. Methods: Eighteen patients in need of extraction of maxillary anterior teeth were selected and randomly assigned to the test group (ADM plus ABM/P‐15) or the control group (ADM only). Clinical measurements were recorded initially and at 6 months after ridge‐preservation procedures. Results: In the clinical measurements (external vertical palatal measurement [EVPM], external vertical buccal measurement [EVBM], and alveolar horizontal measurement [AHM]) the statistical analysis showed no difference between test and control groups initially and at 6 months. The intragroup analysis, after 6 months, showed a statistically significant reduction in the measurements for both groups. In the comparison between the two groups, the differences in the test group were as follows: EVPM = 0.83 ± 1.53 mm; EVBM = 1.20 ± 2.02 mm; and AHM = 2.53 ± 1.81 mm. The differences in the control group were as follows: EVPM = 0.87 ± 1.13 mm; EVBM = 1.50 ± 1.15 mm; and AHM = 3.40 ± 1.39 mm. The differences in EVPM and EVBM were not statistically significant; however, in horizontal measurement (AHM), there was a statistically significant difference (P<0.05). Conclusion: The results of this study show that ADM used as membrane associated with ABM/P‐15 can be used to reduce buccal‐palatal dimensions compared to ADM alone for preservation of the alveolar ridge after extraction of anterior maxillary teeth.     

帐篷螺丝技术在上前牙区连续缺失种植修复中的疗效评价

目的:评价帐篷螺丝植骨技术在上前牙区连续多牙缺失水平向骨增量术中的临床应用效果。方法:使用帐篷螺丝技术(screw-tent technique)对9例上前牙连续缺失(21个位点),骨缺损严重的患者进行水平向骨增量,6~9个月后行种植体植入术,植入术后6个月行种植修复,并追踪观察修复后12个月的修复效果。结果:9例患者共植入21枚种植体,无一松动或者脱落,并获得较满意的修复效果。术前牙槽嵴宽度为(2.41±0.49)mm,术后6个月牙槽嵴宽度为(8.27±0.79)mm,对比植骨术前和术后,差异有统计学意义(P<0.05)。修复完成后12个月牙槽嵴宽度为(7.74±0.52),对比种植术后和修复后12个月,差异有统计学意义(P<0.05)。结论:螺丝技术在上前牙连续缺失的水平向骨增量中,可获得较理想的水平向骨增量效果及修复效果。但由于观察时间较短,其远期效果仍需要进一步的观察研究。