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目的评价牙槽嵴唇(颊)鄂(舌)向宽度不足的患者联合应用骨劈开、骨挤压术及引导骨组织再生(GBR)技术并同期种植的短期临床疗效。方法选取2009—2014年就诊于中国医科大学附属口腔医院种植中心的患者24例,联合应用骨劈开、骨挤压术,植入54枚种植体后同期植入骨粉,行GBR技术,术后4~6个月内完成上部结构修复。将54枚种植体按不同植入部位分为上颌前牙区、上颌后牙区、下颌前牙区及下颌后牙区4组,通过临床检查、X线片及锥形束CT(CBCT)等观察比较4组种植体手术前后及术后半年牙槽骨宽度的变化,修复后6个月及1年的骨高度变化等。结果种植手术当天至修复后1年的临床随访检查显示,无种植体松动,全部种植体行使功能良好,存留率100%。种植术后牙槽骨宽度与术前相比,差异有统计学意义(P<0.05)。牙槽骨宽度在术后与术后半年的对比中,差异无统计学意义(P>0.05)。术后半年,比较4组植入部位的骨宽度变化,差异无统计学意义(P>0.05)。修复后6个月及1年,比较4组植入部位的骨高度变化,差异均无统计学意义(P>0.05)。结论对牙槽嵴唇(颊)鄂(舌)向宽度不足的患者,联合应用骨劈开、骨挤压术和GBR技术并同期种植,可增加骨量,达到牙槽嵴宽度的水平扩增。不同种植部位对种植体周围骨组织吸收量没有明显影响。
Objective To evaluate the short-term clinical efficacy of simultaneous application of osteotomy, osteosynthesis and guided bone regeneration (GBR) in patients with under-width alveolar lip (buccal) lip (buccal). Methods Twenty-four patients were enrolled in the Affiliated Stomatological Hospital of China Medical University from 2009 to 2014. Bone splitting and osteotomy were performed in combination with 54 implants. Bone meal was implanted in the same period. GBR technique was performed. 4 to 6 months to complete the superstructure repair. The 54 implants were divided into 4 groups: maxillary anterior teeth area, maxillary posterior teeth area, mandibular anterior teeth area and mandibular posterior teeth area according to different implants. Through clinical examination, X-ray and cone beam CT (CBCT) The changes of alveolar bone width before and after operation and after operation for 6 months and one year after operation were observed and compared. Results The clinical follow-up examination from the day of implant surgery to 1 year after repair showed that no implant was loosened and all the implants performed well and the retention rate was 100%. The width of alveolar bone after planting was significantly higher than that before operation (P <0.05). There was no significant difference in alveolar bone width between postoperative and six months postoperatively (P> 0.05). Six months after operation, there was no significant difference in bone width between the four groups (P> 0.05). At 6 months and 1 year after repair, the differences of bone height between the 4 groups were not statistically significant (P> 0.05). Conclusion Combined application of osteotomy, osteosynthesis and GBR techniques in the same period of planting of the alveolar lip (buccal) jaw (width) can increase the bone mass and achieve the level of alveolar ridge width . Different implant sites had no significant effect on the amount of bone tissue around the implant.