【作者】 邱立新； 陈波； 王莺； 胡秀莲； 张宇； 邸萍； 李健慧； 林野；

【Author】 QIU Lixin,CHEN Bo,WANG Ying,HU Xiulian,ZHANG Yu,DI Ping,LI Jianhui,LIN Ye (Department of Oral Implantology,Peking University School of Stomatology)

【机构】 北京大学口腔医学院种植中心；

【摘要】 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,软组织瓣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Fürhauser的改良红色美学指数(Defined pink esthetic 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1.91 mm。.13例完成永久修复,并观察1年以上,软组织美学效果,采用Fürhauser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。更多还原

【Abstract】 Object:To evaluate prospectively the clinical result of GBR using non - resorbable titanium membrane in single maxillary implant site either with coronal bone fenestration presented or with thin labial bone of less than 0.5mm.Method and material:From June,2004 to December, 2008,18 consecutive patients treated in the department of Oral Implantology,Peking University School of Stomatology were enrolled in this study.These patients(12 males,6 females,mean age of 38.6 years old ranging from 19-56 ys) all underwent single implant replacement for maxillary anterior tooth..Either bone fenestration occurred in the coronal part of the implant or the remaining labial bone was less than 0.5mm after implant placement.They were all non-smokers and were healthy.Guided bone regeneration was performed with autogenous bone,Bio-Oss(from Geitlich,Switerland) and non -resorbable titanium membrane.Titanium tack was used to stabilize the membrane.Tension free wound closure was achieved.Second stage surgery was performed 6 months later and titanium membrane was removed.The thickness of labial bone was evaluated.Implant restoration was done 2 months after second stage surgery.The clinical result of restoration was evaluated.Soft tissue around implant restoration was evaluated using Modified Pink Esthetic Score according to the standard of F(u|¨)rhauser.Result:Of the 18 patients,none had wound dehiscence or infection.All 18 implant abtained osseointegration verified by X-ray examination.The mean value of labial bone thickness was 0.17mm upon implant placement.Titanium membrane was removed at second stage surgery and the mean value of labial bone thickness increased to 1.5mm-3.5mm,with an average of 2.14mm(increase by 1.91mm as compared to that before GBR).13 patients had definite crown already and had been observed for more than 1 year.Soft tissue esthetics was evaluated according to PES by F(u|¨)rhauser standard.The value of PES after restoration was 9 to 14,with an average of 12.15.The mean value of soft tissue convexity was 1.85mm.Conclusion:Using titanium membrane in GBR seemed to be able to achieve predictable clinical outcome in the treatment of bone dehiscence and deficiency of labial bone thickness in single maxillary implant site.更多还原