引导骨组织再生技术在牙种植修复中的临床应用研究

目的 评价引导骨再生技术在牙种植中引导骨再生修复的方法和效果。方法 对80例牙槽骨骨缺损的患者采用植Bio-Oss小牛骨粉，盖Bib-Gide膜或钛膜，进行引导骨再生，修复骨缺损并行骨内种植体周的骨增量。结果 80例患者共植入90枚种植体，38例采用钛膜，42例采用Bio-Gide胶原膜；术后部份患者伤口裂开、膜暴露；Bio-Gide膜与钛膜的伤口裂开发生率分别为7．1％与21．1％。二期手术时观察膜下骨再生情况，无感染患者膜下的新骨生成较膜暴露者多，Bio-Gide胶原膜暴露后自行愈合情况较使用钛膜者理想。88枚种植体成功地完成骨整合并成功完成义齿修复，2枚种植体因钛膜暴露及感染失败。结论 Bio-Gide胶原膜及钛膜皆能有效地屏蔽软组织，引导骨再生，重建牙槽骨外形；术后无伤口裂开、膜暴露者有较好的骨再生效果；与钛膜相比，Bio-Gide胶原膜更为简便易用，出现过早裂开的比率也较少。     

Bio-Oss混合自体骨移植联合膜引导骨再生术在种植中的临床应用

目的：观察Bio-Oss混合自体骨联合膜引导骨再生术应用于牙种植的临床疗效。方法：对临床21例骨量不足的患者Ⅰ期植入种植体，同时植入Bio-Oss与自体骨的混合物，表面覆盖Bio-Gide胶原膜。在术后十天，一月，三月，六月通过临床检查及X线检查评价临床疗效。结果：21例患者植骨区新骨形成良好，牙槽嵴的外形丰满，种植体无动度，均完成了上部修复。结论：Bio-Oss混合自体骨联合膜引导骨再生术应用于种植区骨量不足的患者可取得较好的疗效。     

上颌前牙区单牙种植钛膜引导成骨的美学效果观察

目的上颌前牙单牙种植采取不可吸收性无孔纯钛膜进行引导骨再生,对成骨效果以及修复后软组织美学效果进行观察。方法 2004年6月至2009年12月,在北京大学口腔医学院种植中心,20例上颌前牙单牙缺失种植患者（男12例,女8例,年龄19~56岁,平均34.0岁）。种植体植入后唇侧颈缘出现裂开性骨缺损或唇侧骨板厚度小于等于0.5mm,采用少量自体碎骨和Bio-Oss骨粉充填骨缺损后,以钛膜覆盖植骨区,并用小膜钉固定。愈合5~6个月行Ⅱ期手术,取出钛膜,测量种植体唇侧骨板的厚度。Ⅱ期术后2个月进行种植修复。使用PES（pink esthetic score）评分对种植修复体周围软组织进行评价。结果 20例病例中,没有一例出现伤口的裂开及感染。20颗种植体均获得骨结合。种植体植入时,唇侧骨板的厚度平均0.23mm,种植Ⅱ期手术暴露种植体取出钛膜时,测量唇侧骨板的厚度为1.5mm~3.5mm,平均2.33mm,平均增加2.10 mm。PES平均得分为10.05±1.57。结论在上颌前牙区单牙种植时,采取钛膜引导成骨,解决种植体唇侧颈部骨板裂开性骨缺损及厚度不足效果可靠,牙龈软组织的近期效果良好。     

Bio-Oss与引导骨再生胶原膜联合植入牙槽嵴裂的临床观察

目的 观察进入青春期唇腭裂的患者鼻畸形修复及牙槽嵴裂同期植入天然多孔骨无机材料(Bio-Oss)及可吸收双层生物胶原膜(Bio-Gide)的临床效果。方法 对30例同期行牙槽嵴裂植入天然多孔骨无机材料及可吸收双层生物胶原膜与鼻畸形修复进行研究，对术后随访的X线片进行效果客观评价。结果 随访6～12月，其中1例拆线后牙龈处伤口裂开，但无Bio-Oss颗粒脱出，经换药伤口愈合。其余效果满意。结论 对于错过植骨最佳时期进入青春期的患者，牙槽嵴裂植入天然多孔骨无机材料能够代替植入的松质骨，避免再开辟第二术区给患者造成痛苦，联合应用可吸收双层生物胶原膜，进一步保障了植入天然多孔骨无机材料的成功。     

上颌前牙单牙种植区采用钛膜引导成骨的效果观察

研究目的:上颌前牙单牙种植区,种植体颈部唇侧裂开性骨缺损或唇侧骨板厚度小于0.5mm时,采取不可吸收性钛膜引导成骨的效果及修复效果的前瞻性研究.材料及方法:2004年6月-2008年12月,在北京大学口腔医学院种植中心,18例上颌前牙单牙缺失患者(男12例,女6例,年龄19-56岁,平均38.6岁),要求采取种植修复,身体健康,不吸烟.种植体植入后唇侧颈缘出现裂开性骨缺损或唇侧骨板厚度小于0.5mm,采用少量自体碎骨和瑞士盖式Bio-Oss骨粉充填骨缺损后,不可吸收性钛膜覆盖植骨区,并用小膜钉固定钛膜,软组织辫充分缓冲无张力后关闭术区.愈合6个月后行二期手术,取出钛膜,测量种植体唇侧骨板的厚度.二期术后2个月进行种植修复,修复效果的观察,采用Furhauser的改良红色美学指数(Defined pink es-thetic score)观察种植体修复后的软组织美学效果.结果:18例病例中,没有一例出现伤口的裂开以及感染.放射学观察18颗种植体均获得骨结合.种植体植入时,唇侧骨板的厚度(平均0.17mm),种植二期手术,即暴露种植体取出钛膜时,测量唇侧骨板的厚度为1.5mm-3.5mm,平均2.14mm,平均增加1.91mm..13例完成永久修复,并观察1年以上,软组织美学效果,采用Furhauser的红色美学指数,PES最高得分14分,最低得分9分,平均12.15分,龈缘水平线位置平均为1.77mm,牙根区的软组织的凸度平均为1.85mm,此两项得分较高,与植骨及成骨效果有密切关系.结论:在上颌前牙区单牙种植时,采取不可吸收性钛膜引导成骨,解决种植体唇侧颈部骨板裂开性骨缺损及厚度不足效果可靠.     

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。     

海奥口腔修复膜与Bio-Gide胶原膜在即刻种植牙膜引导骨再生治疗中的疗效观察

目的:探讨海奥口腔修复膜修复及Geistlich Bio-Gide胶原膜修复在即刻种植牙膜引导骨再生的疗效。方法:选择2020年1月～2023年1月于本院行即刻种植牙的78例患者作为研究对象,采用随机数字表法分为A组(n=39)及B组(n=39)。给予A组患者海奥口腔修复膜修复,B组则采用Geistlich Bio-Gide胶原膜修复。比较两组植骨情况、术后疼痛程度[视觉模拟评分量表(visual analog scale, VAS)]、种植修复效果,并统计并发症发生情况。结果:B组患者植骨厚度、植骨高度、成骨厚度、成骨高度、水平骨成长效果及垂直骨生成效果均高于A组(P<0.05)。术后3个月B组患者VAS评分低于A组(P<0.05)。B组种植成功率高于A组,且B组并发症总发生率低于A组(P<0.05)。结论:与海奥口腔修复膜比较,Geistlich Bio-Gide胶原膜修复能改善即刻种植牙膜引导骨再生治疗患者植骨情况与种植修复效果,且有助于降低术后疼痛程度与并发症发生率。     

不同口腔修复膜材料对牙种植中骨再生影响情况研究

目的探究和分析不同口腔修复膜材料在牙种植中对骨再生的影响。方法选取2013年4月—2014年4月我院进行牙种植骨再生术的64例患者为研究对象,按照骨再生的引导时采用的口腔修复膜材料不同分为观察组和对照组,观察组采用Bio-Gide生物膜,对照组采用钛膜,观察记录两组患者修复成功的情况、植骨厚度、1周后骨厚度以及不良反应的发生情况,并进行分析比较。结果观察组患者手术修复成功率为100%,对照组患者手术修复成功率为81.25%,两组患者的手术修复成功率(χ2=6.5172,P=0.0107)、植骨密度(t=5.2894,P=0.0000)、骨厚度(t=6.2960、P=0.0000)、总不良反应发生率(χ2=6.5172,P=0.0107)差异具有统计学意义。结论 Bio-Gide生物膜在牙种植术中的应用对骨再生的引导作用显著,手术成功率高,重新建立牙槽骨外形,有利于植骨和骨再生,具有高度的临床使用价值。     

纯钛膜在种植外科中应用效果的初步研究

目的 评价无孔纯钛膜治疗种植体周围骨缺损的临床效果，并探讨其应用技巧。方法 81例患者的92颗种植体周围骨缺损均采取自体碎骨及Bio-Oss人工骨移植充填后，国产无孔纯钛膜覆盖治疗，术后6～10个月行种植Ⅱ期手术，同时取出钛膜。结果 5例(6颗种植体)发生种植术后软组织瓣早期裂开或穿孔，钛膜外露且早期取出；其余76例软组织瓣愈合良好，原骨缺损完全骨性修复。结论 钛膜有良好的生物相容性，有效地防止移植的骨代用品移位、纤维结缔组织长入，其塑形性好，能维持较大的骨再生修复空间，骨生成量大。     

BIO-OSS人工骨与不同比例自体骨联合植入修复骨质缺损的实验研究

目的:建立种植体周围骨缺损的模型,植入自体骨、Bio-Oss人工骨、以及不同组成比例的骨移植物,比较新骨生成的效果.方法:拔除4条犬双侧下颌8颗双尖牙,拔牙12周后在每只实验犬两侧下颌植入8个钛钉,共32枚.分别于钛钉颊侧制造3ram*3mm*3mm的骨缺损.两侧自前向后依次植入收集的自体骨、1:2的Bio-Oss骨粉和自体骨混合物、2:1的Bio-Oss骨粉和自体骨混合物、单纯Bio-Oss骨粉,左侧覆盖钛膜,右侧覆盖胶原膜,严密缝合所有创口.植骨17周后取材,拍摄X线片,制作含钛钉的硬组织切片,光镜下观察.结果:4条试验犬32颗种植体术后均无感染,植骨区创口愈合良好.钛膜及胶原膜组均无暴露.切开粘膜可见32个人工制造骨缺损处光滑,坚硬,已经被新生骨组织充满.X线可见两种膜覆盖的区域种植体与骨结合紧密,无透射阴影,骨密度略有增高.全自体骨处骨密度略高于混合人工骨处.不同比例混合骨粉和自体骨以及全骨粉处成骨未见差异.在光镜下观察硬组织切片可见自体骨处成骨质量较高,其他三种植骨方式成骨差异不大,钛膜及胶原膜组相比亦未见成骨差异.讨论:本试验显示不同比例的骨移植物成骨效果未见差异,证实了Bio-Oss具有良好的生物相容性.与其他骨移植材料联合使用可获得理想的成骨效果.屏障膜可以完全封闭缺损区,且从缺损区周围正常骨组织获得足够的支撑.结论:不同组成比例的骨移植物对新骨生成作用未见差异,胶原膜与钛膜联合骨移植材料在引导骨再生中均能获得理想效果.     

钛网+膜联合使用修复种植体周围牙槽骨缺损的实验研究

目的 探讨联合使用钛网+Bio-Gide膜修复比格犬种植体周围牙槽骨缺损的效果。方法 选择3只成年比格犬,拔除双侧下颌P1-M1,牙槽窝愈合6个月。将3只比格犬（共6侧）随机分为3组,A组使用种植体+骨粉+钛网,B组使用种植体+骨粉+Bio-Gide膜,C组使用种植体+骨粉+钛网+Bio-Gide膜。每侧选取3个位点制备种植窝,在颊侧制作4 mm×4 mm×4 mm牙槽骨缺损,植入种植体并分别覆盖钛网或Bio-Gide膜。于术后6个月处死动物并取材,Micro-CT扫描并三维重建。使用SPSS17.0软件包对测量结果进行统计学分析。结果 Micro-CT扫描及三维重建结果显示,C组的骨小梁数目、骨小梁厚度、骨密度等数据显著高于另外两组（P<0.01）,骨小梁分散度显著低于另外两组（P<0.01）。结论 联合使用钛网+Bio-Gide膜,对比格犬种植体周围牙槽骨缺损的修复作用显著优于单纯使用钛网或Bio-Gide膜。     

Sinus augmentation utilizing anorganic bovine bone (Bio-Oss) with absorbable and nonabsorbable membranes placed over the lateral window: histomorphometric and clinical analyses

The purpose of the present study, which used anorganic bovine bone (Bio-Oss) with and without autogenous bone as the augmentation material, was to compare the results of sinus elevation performed without a membrane (control) with the results of sinus elevation performed with either a short-term bioabsorbable membrane (Bio-Gide) or a nonabsorbable membrane (Gore-Tex) with regard to both vital bone formation and implant survival. Sinus lifts were performed on 51 patients (38 unilateral, 13 bilateral) with the delayed placement of 135 implants. Histomorphometric data were obtained at the time of implant placement, 6 to 10 months following the grafting procedure. Vital bone formation was 17.6%, 16.9%, and 12.1%, respectively, for the Bio-Gide, Gore-Tex, and no membrane groups. Of the 135 implants placed there were 3 failures (2 Bio-Gide, 1 Gore-Tex). There was no significant difference between the membrane groups as to vital bone formation and implant survival.     

15例上颌前牙种植的美学临床研究

目的：评价ITI种植系统用于上颌前牙列缺损修复的临床应用和短期疗效并总结牙种植治疗中的经验教训。方法：50例患者的缺牙区植入ITI种植体78颗并完成义齿修复,临床观察12～36个月,其中15例为上颌前牙区种植美学修复。6例上颌植入区骨量不足者,用Bio-Oss人工骨粉植入缺损区及Bio-Gide可吸收生物膜覆盖。结果：50例患者总共78颗种植体稳固无松动,种植部位无疼痛或不适,短期种植成功率100%。2颗上颌前牙种植修复后牙龈乳头缺失。患者满意度为92.3%。结论：ITI种植系统在牙列缺损修复中有的成功率很高,但患者对前牙缺损修复美学效果要求也越来越高,软组织的处理对最后的美学效果十分重要。     

Ridge enlargement using deproteinized bovine bone and a bioresorbable collagen membrane: a tomodensitometric, histologic, and histomorphometric analysis

The aim of this paper was to study, through a clinical case report, the behavior of deproteinized bovine bone (Bio-Oss) covered with a resorbable barrier membrane (Bio-Gide) when used as an onlay grafting material to obtain alveolar bone ridge enlargement. The presence of an existing bone edge allowed placement of an MK III groovy implant and creation of the required space for ridge enlargement, using xenograft particles (Bio-Oss) covered with a resorbable barrier membrane (Bio-Gide), during the same surgical stage. Recording of anatomical landmarks in the three dimensions of space in relation to implant position allowed precise assessment of the graft behavior during the tomodensitometric examinations performed at 6 and 18 months postsurgery. A biopsy was performed at 9 months postsurgery for histologic and histomorphometric analyses. The tomodensitometric images allowed observation of the preservation of the grafted bone volume. The histologic analysis revealed vital bone formation with the remaining Bio-Oss particles; the histomorphometric analysis, at this stage, provided similar percentages of Bio-Oss (27.94%) and newly formed bone (24.07%). This clinical example confirms the biocompatible and osseoconductive properties of Bio-Oss, as well as stability of the bone graft volume. These different elements testify to the advantage of its use for alveolar ridge enlargement.     

Alveolar ridge augmentation with Bio-Oss: a histologic study in humans

The aim of the present study was to investigate the healing of alveolar ridge defects augmented with cancellous bovine bone mineral. In six partially edentulous patients, bone augmentation was necessary prior to implant placement because of severe alveolar ridge resorption. The defect sites, all located in the maxilla, were filled with Bio-Oss and covered with the resorbable collagen membrane Bio-Gide. Biopsies were obtained from the defect sites 6 to 7 months following grafting and were processed for ground sectioning. The histologic analysis revealed that the Bio-Oss particles occupied 31% of the total biopsy area. An intimate contact between woven bone and Bio-Oss was detected along 37% of the particle surfaces. A mixed type of bone was found; it contained woven bone and parallel-fibered bone, which demonstrates features of remodeling activity. Signs of resorption of the grafting material were observed in the histologic sections, which indicates that the material takes part in the remodeling process. It is suggested that Bio-Oss may be a very suitable material for staged localized ridge augmentation in humans.     

Composite bone graft for treatment of osseous defects after surgical removal of impacted third and second molars: case report and review of the literature

The aim of this case report was to evaluate the clinical and radiographic measurements of mandibular first molar bone support after mandibular third and second molar extraction and immediate augmentation of the extraction site with a combined autogenous bone graft with Bio-Oss materials. A pyramidal full-thickness mucoperiosteal flap with 1 distal releasing incision was used for removal of impacted third and second molars. During the procedure, autogenous bone graft was collected with a bone trap and then combined with Bio-Oss materials. The osseous defects distal to first molar and extraction site was filled with the composite bone graft and covered with Bio-Gide membrane. After 1 year, there was a successful defect regression and gain of bone and clinical attachment level. Moreover, there was a reduction of probing pocket depth and gingival inflammation. From the results of this study, it can be concluded that grafting of osseous defects and extraction site with autogenous bone graft combined with Bio-Oss materials will predictably result in a decreased risk of developing a periodontal defect on the distal aspect of mandibular first molar.     

自体骨碎末与复合移植修复种植体周围骨缺损的比较研究

目的：研究自体骨碎末与混入Bio-Oss复合移植修复种植体周围骨缺损的效果。方法：9周及16周后对种植体周围骨缺损处植入自体骨末、自体骨末与Bio-Oss二者1：1混合骨末及未植骨进行比较。结果：植入的自体骨碎末恢复了一定的骨缺损,混合Bio—Oss组恢复最佳。各组16周时骨整合均优于9周。结论：植入钻孔时收集的自体骨碎末对于恢复种植体周围少量的骨缺损,是完全可行的。自体骨碎末作为供骨量不足时,可以混合适当的Bio—Oss颗粒行复合移植,效果更为理想。     

Long-term results of implants treated with guided bone regeneration: a 5-year prospective study.

The aim of this prospective 5-year longitudinal study was to follow endosteal implants in which guided bone regeneration (GBR) was applied during implant placement. In 75 patients, defects around implants (Branemark System) were treated with Bio-Oss and Bio-Gide (112 implants). In split-mouth patients in this group, Bio-Oss and Gore-Tex were used in the second defect site (41 implants). All 75 patients had at least 1 implant that was entirely surrounded by bone and served as the control (112 implants). After placement of the definitive prostheses (single-tooth, fixed, or removable implant prostheses), patients were recalled after 6 months and then every 12 months during a 5-year observation period. The following variables were investigated: implant survival, marginal bone level (MBL), presence of plaque, peri-implant mucosal conditions, height of keratinized mucosa (KM), and marginal soft tissue level (MSTL). The cumulative implant survival rate after 5 years varied between 93% and 97% for implants treated with or without GBR. The mean MBL after 60 months was 1.83 mm for sites treated with Bio-Oss and Bio-Gide, 2.21 mm for sites treated with Bio-Oss and Gore-Tex, and 1.73 mm for the control sites. The MBL values were found to increase significantly with time and differed significantly among the treatment groups. During the observation period, KM varied between 3.16 and 3.02 mm. A slight recession of 0.1 mm was observed, and plaque was found in 15% of all sites and was associated with inflammatory symptoms of the peri-implant mucosa. It was observed that such symptoms and recession correlated more strongly with the type of restoration than with the type of treatment. This study demonstrated that implants placed with or without GBR techniques had similar survival rates after 5 years, but that bone resorption was more pronounced in sites with GBR treatment. It was assumed that the use of GBR is indeed indicated when the initial defect size is larger than 2 mm in the vertical dimension.     

Periodontal regeneration with an autogenous bone-Bio-Oss composite graft and a Bio-Gide membrane

This study evaluated the clinical, radiographic, and histologic response to the composite use of Bio-Oss porous bone mineral and autogenous bone in combination with a Bio-Gide bilayer collagen membrane to achieve regeneration when treating human periodontal bone defects. Preoperative recordings for four treatment areas included radiographs, clinical probing depths, and attachment levels; these recordings were repeated at 9 months. Histologic evaluation revealed new cementum with inserting collagen fibers and new bone formation on the surface of both types of graft materials. This grafting combination not only compared favorably with the previous use of Bio-Oss and Bio-Gide, but exceeded that result with almost complete periodontal regeneration. This human histologic study demonstrates that autogenous bone in combination with porous bone mineral matrix, together with the Bio-Gide collagen membrane, has the capacity to stimulate substantial new bone and cementum formation with Sharpey's fiber attachment.     

Reconstruction of severely resorbed alveolar ridge crests with dental implants using a bovine bone mineral for augmentation

This study reviews the outcome of implant placement in 61 patients after augmentation of severely atrophic alveolar bone with a bovine bone mineral, Bio-Oss. Bone augmentation was performed at 4 different sites: alveolar crest width, alveolar crest height, antral cavity, or nasal cavity. After a mean healing time of 11.9 months, 231 implants were placed in Bio-Oss bone. The time of loading of the implants varied between 12 and 113 months. Calculated from the time of implant placement and irrespective of loading time, a survival rate of 80.5% for the individual implants was estimated. In most patients (73%), Bio-Oss was mixed with autogenous bone from the chin. However, the results indicated that autogenous bone may be excluded from the Bio-Oss graft.