血浆基质在口腔种植水平骨增量中的应用

牙齿缺失伴随着牙槽骨吸收或缺损,导致骨量和软组织量不足。种植治疗除恢复缺失牙的咀嚼功能外,还需恢复牙弓的轮廓和外形,引导骨再生术是骨增量的常用手段。异种颗粒状骨替代材料因其降解时间长、免疫反应低等优点,在临床水平骨增量领域应用广泛,但存在操作不便、成骨活性低等问题。血浆基质能有效提高口腔组织再生效果、减少术后并发症的出现,在口腔组织再生中的应用逐渐增多。本文首先介绍了血浆基质在水平骨增量中的主要应用形式(固态血浆基质膜、血浆基质骨块),并根据临床常用的骨增量决策方案,即是否能够在理想位置植入种植体以及植入后是否存在骨开裂对水平骨缺损进行重新分类,其中Ⅰ类水平骨缺损为缺牙位点骨量可供植入理想尺寸的种植体,且种植体周围无骨开裂,但牙槽骨轮廓比非缺牙区凹陷的情况;Ⅱ类水平骨缺损为缺牙位点骨量根据未来修复体位置确定的种植位点植入理想尺寸种植体后,种植体三侧均有骨,但颊侧骨壁存在骨开裂(骨开裂长度小于种植体长度的50%)的情况;Ⅲ类水平骨缺损为缺牙位点骨量不足以在理想位置植入理想尺寸的种植体,需要先行植骨恢复骨量以利于种植体植入的情况。本文随后对血浆基质在不同水平骨缺损类型中的应用方法进行阐述:...

Application of plasmatrix in horizontal bone augmentation for implant placement

Tooth loss is accompanied by alveolar bone absorption or defect,resulting in insufficient bone and soft tis?sue.In addition to restoring the masticatory function of missing teeth,implant treatment should also needs to restore the contour and shape of the dental arch.Guided bone regeneration is a common means of bone increase.Xenogeneic granu?lar bone substitute materials are widely used in the field of clinical bone augmentation due to their advantages of long degradation time and low immunogenicity,but other problems,such as inconvenient operation and low osteogenic activi?ty,remain.Plasmatrix can effectively improve the effect of oral tissue regeneration and reduce the occurrence of postop?erative complications,and its application in oral tissue regeneration is gradually increasing.This article first introduces the main application forms of plasmatrix in horizontal bone augmentation(mainly solid plasmatrix membrane and plas?matrix bone block),and reclassifies horizontal bone defects according to commonly used decision?making schemes in clinical bone augmentation,in other words,whether the implant can be placed in the ideal position and whether there is bone dehiscence after implantation.TypeⅠdefects refers to the situation where the bone at the implant site can allow the insertion of an implant with ideal size,and there is no bone dehiscence around the implant,but the alveolar bone contour is not ideal;typeⅡdefects refers to the situation that when an ideal size implant is placed at the implant site determined by the future prosthesis position,there will be bones on three sides of the implant,but there is bone dehis?cence in the buccal bone wall(the length of bone dehiscence is less than 50%of the implant length);typeⅢdefects re?fers to the situation where the bone volume at the implant site is not enough to for the placement of the ideal size im?plant at the ideal position,and bone grafting is required to restore the bone volume before the implant placement.The application of plasmatrix in different types of bone defects is then described.In typeⅠbone defects,the solid plasma?trix membrane is used instead of the collagen membrane;in typeⅡbone defects,the bone defect around the implant is filled by plasmatrix bone block and then covered with collagen membrane and solid plasmatrix membrane;and in typeⅢbone defects,plasmatrix bone block is used to replace autogenous bone block to fill the defect area,and titanium screws are used for fixation.The defect is then covered with a collagen membrane and a solid plasmatrix membrane.This article aims to provide oral clinicians with a comprehensive understanding of plasmatrix and simplify the guide?lines for bone regeneration operations.