钛膜和胶原膜联合应用引导种植体周骨缺损骨再生的临床研究

目的：评价钛膜与胶原膜联合应用引导种植体骨缺损骨再生的临床效果。方法：将34颗种植体植入30例患者的狭窄形牙槽嵴或唇颊骨壁缺损拔牙窝,所有种植体的唇、颊侧面部分暴露,种植体周骨缺损空间维持能力较差。测量种植暴露部分的最大长度,将羟基磷灰石珊瑚骨粉置于骨缺损处,采用钛膜覆盖稳定骨移植材料,然后将胶原膜覆盖于钛膜表面,无张力缝合伤口,术后6个月行Ⅱ期手术,取下钛膜,检查骨缺损骨再生的状况,再次测量种植暴露部分的最大长度。结果：2例患者于手术3个月左右因钛膜局部暴露,将钛膜取出。钛膜暴露率为6.6%。术后6个月Ⅱ期手术时见,所有种植体暴露部分完全被再生骨覆盖,种植体暴露部分长度为0。结论：在空间维持能力较差的骨缺损处,钛膜和胶原膜联合应用引导骨再生可获得理想结果。钛膜和胶原膜联合应用可显著降低钛膜的暴露率,延迟发生膜暴露的时间,从而使引导骨再生的结果更加具有可预测性。

Clinical Study of Guided Bone Regeneration in Peri-implant Bone Defects with Combining Titanium Membrane and Collagen Membrane

Objective： To clinically evaluate the effect of guided bone regeneration （GBR） with combining titanium membrane and collagen membrane in peri - implant bone defects. Methods： 34 implants were placed in 30 patients with thin alveolar ridges and the postextraction sockets with buccal bone defect. The buccal aspect of all implants were exposed and the peri - implant bone defects were with less space making feature . The maximum exposed length of the implants was measured. The bone defects were covered with HA - coral particles and first covered with titanium membranes then covered with collagen membrane again. Passive flap adaptation and tension -free closure was obtained. The titanium membranes were removed 6 months later and the new formed bone was observed and the maximum exposed length of the implants was measured again. Results ： The titanium membranes of 2 cases were exposed and removed after 3 months. The exposed rate of titanium membrane was 6.6%. 6 months postoperatively, all peri - implant bone defects were completely covered with new formed bone. Conclusion ： For the peri - implant bone defect with less space - making featuer, the satisfying effect of GBR canbe obtained by combining the titanium membrane and collagen membrane.