异体脱细胞组织补片修复即刻牙种植软组织创面的临床研究

目的 评价异体脱细胞组织补片（又称异体脱细胞真皮基质补片，简称补片）修复即刻牙种植创面的临床疗效。方法 应用异体脱细胞组织补片修复51例患者、67个牙位的即刻种植后口腔黏膜缺损创面，将补片的基底面向上，覆盖于种植体及牙槽嵴上，并插入黏骨膜瓣下，碘仿纱包或预成基托固定。术后随访4～6个月，对口腔补片修复创面的愈合情况及组织病理结果观察。种植体骨结合情况随访6个月～4年。结果 术后创面完全封闭愈合54个牙位，部分封闭愈合11个牙位，未封闭愈合2个牙位。无排斥反应。经4～6个月后组织病理检查补片已完全黏膜上皮化，67颗种植体情况经1年观察，无一例失败。结论 异体脱细胞组织补片具有良好的即刻种植创面封闭作用，不影响种植体与骨的结合，且具有手术创伤小、修复美学效果好等优点，可以作为牙即刻种植创面的修复材料。

Clinical study of repair the defect of immediate implant by acellular dermal matrix

OBJECTIVE: To evaluate the clinical effect of acellular dermal matrix allograft in repairing the oral mucosal defect of immediate implant. METHODS: 51 cases underwent immediate implant surgery for 67 implants right after the teeth or roots extracted. The mucosal defect of implant areas were repaired by acellular dermal matrix. The basal membrane side of acellular dermal matrix was exposed to oral cavity, and another side was attached to the implant and alveolar crest surface. It was intercalated between mucosal flap and alveolar and fixed by iodoform pack or base plate. To understand condition of wound healing the patients were followed up from 4 months to 6 months after operation. The acellular dermal matrix closed wound and histological changes were observed. The implant was followed up months to 4 years. RESULTS: The wounds were completely healed in 54 implant areas, partially healed in 11 implant areas, not healed 2 implant areas. histological examination wasn't differentiation between mucous epithelium and graft epithelium. None of 67 implants showed deterioration in the follow-up of one year. It was no obvious sign of immune rejection. CONCLUSION: The clinical result of acellular dermal matrix in repair the mucosal defect of immediate implant is good, the advantages are not to affect the integration bone with implant, less operation trauma, good esthetics results.