不同种属的脱细胞真皮基质做屏障膜的近期临床评价

目的：观察在牙种植术中分别采用异体、异种脱细胞真皮基质（AcellularDermalMatrix,ADM）做屏障膜完成引导骨再生（Guided Bone Regeneration,GBR）术后,手术位点的软硬组织愈合过程的临床差异,评价两种不同的ADM临床应用的价值。方法：32例因上颌单个前牙缺失要求行种植修复的患者,种植体植入术中发现种植体颈部骨缺损,按患者就诊时间先后分为两组,前12例作为对照组,采用异体ADM做为屏障膜,后20例作为实验组,采用异种ADM做为屏障膜,两组患者均于种植术同期以GBR技术修复种植体颈部骨缺损。术后1周,2周,1个月,6个月复诊时,观察记录①两组伤口愈合的情况;②附着龈宽度变化;③术后即刻与术后6个月全景片上种植体颈部骨缺损修复情况。结果：1）实验组和对照组伤口均一期愈合。2）附着龈宽度同组内术后较术前减少,有统计学差异;组间无论术前术后均无统计学差异。3）X线检查术后即刻与术后6个月比较,种植体颈部平均有明显骨吸收,组间没有统计学差异。结论：在观察期内两种不同种属的ADM具有相近的临床效果,临床用做屏障膜完成GBR术是安全的,但需要针对膜的不同性状采用不同的技术手段。

A short term clinical evaluation of applying ADM from different species as a barrier membrane

Objective：To evaluate the clinical effects of GBR applying xenogenic and allogenic ADM as a barrier membrane.Methods：32 patients,asking for dental implant to restorate their missed single front tooth,were found bone defects at the buccal wall of implant neck after implant installed.The patients were individed to two groups chronologically.The first 12 patients,controlled group,apply allogenic ADM,while the last 20,experimental group,apply xenogenic ADM as a barrier membrane for completing the GBR technique to repair the bone defects.Observed and recorded the wound recovery situation,attached gingival width and bone defects repair after operation respectively.Results：1） The wound has healed well in both groups after operation.2） Compareing the preoperative and the postoperative,attached gingiva width within the same group reduced statistically after operation,but no significant difference was found between two groups＇ on attached gingiva width no matter postopertion or preoperation.3） The average margin bone lossed obviously in two groups,and there is no statistical significant between two groups.Conclusions：Within the observation period,the ADM of different species have similar clinical effects,both can be used as a barrier membrane in GBR technique.