摘要
目的 :评估采用超声骨刀去骨拔除阻生下颌第三磨牙时,自体骨回植对第二磨牙远中骨缺损的修复效果。方法:将纳入符合标准的51例患者随机分为对照组(C)和自体骨植骨组(T)。术前进行牙周洁治,术中采用超声骨刀去骨拔牙。实验组中取下的自体骨回植到第二磨牙远中骨缺损处。记录所有患者手术情况和术后1周反应,并在术前、术后1周、术后6个月和12个月时拍摄锥形束CT(Cone-beam CT,CBCT)。采用Dolphin软件测量第二磨牙远中牙槽缺损深度(osseous defect depth,ODD),术后6个月和12个月测量M2远中面的探针深度(probing depth,PD)和临床附着水平(clinical attachment level,CAL)。采用SPSS17.0软件包进行统计学分析。结果:2组患者术后第二磨牙远颊角的PD、CAL和ODD均有显著改善(P<0.01);实验组在术后各个时期的CAL和ODD均显著小于对照组(P<0.01)。实验组的术后反应比对照组严重,但无显著差异(P>0.05)。结论 :牙周洁治有利于第二磨牙远中骨缺损的修复;与不植骨相比,植入自体骨可显著修复骨缺损,且无明显不良反应。
PURPOSE： This randomized controlled trial was aimed to evaluate the effect of autogenous bone grafting in situ for regeneration of periodontal osseous defect distal to the M2 compared with non-grafting after removal of impacted M3. METHODS： A total of 60 sites in 51 adult patients were enrolled and randomly assigned to the control group or experimental group. In both groups the M3 was extracted using a piezosurgical device, and the distal root surface of M2 was scaled and root planned. In addition, the removed alveolar bone was grinded to particles and grafted to the distal osseous defect of M2 in the experimental group. The primary outcome variable was the osseous defect depth （ODD）, the secondary outcome variables were pocket probing depth （PD） and clinical attachment level （CAL） on the disto-buccal aspect of M2 during a 12-month follow-up period. Postoperative symptom at 7-day and adverse events were also recorded and analyzed using SPSS 17.0 software package. RESULTS： Six and 12 months after surgery, there was statistically significant bone fill in both groups （/9〈0.01）. Moreover, ODD and CAL in the experimental group were significantly lower than in the control group at each postoperative re-entry （P〈0.01）. Postoperative symptom was more severe in the experimental group than in the control group, but the difference was not significant （P〉0.05）. CONCLUSIONS： The results demonstrated that scaling and root planning was beneficial to periodontal healing of M2 after impacted M3 extraction. Autogenous bone grafting for the treatment of osseous defects distal to M2 was safe and more effective than periodontal treatment alone.
出处
《中国口腔颌面外科杂志》
CAS
2017年第4期334-340,共7页
China Journal of Oral and Maxillofacial Surgery
基金
上海市卫生和计划生育委员会资助项目(201440401)
关键词
阻生下颌第三磨牙
牙周骨缺损
骨再生
随机对照研究
Impacted mandibular third molar
Bone regeneration
Periodontal bone loss
Randomized controlled trial
