目的:在颊侧袋形瓣引导性骨再生手术基础上,探讨放置可吸收胶原膜是否有利于维持术后牙槽嵴轮廓稳定。方法:收集2019年6月至2023年6月因单颗后牙缺失采用种植体植入同期进行颊侧袋形瓣引导性骨再生手术患者,根据骨粉表面是否覆盖胶原膜...目的:在颊侧袋形瓣引导性骨再生手术基础上,探讨放置可吸收胶原膜是否有利于维持术后牙槽嵴轮廓稳定。方法:收集2019年6月至2023年6月因单颗后牙缺失采用种植体植入同期进行颊侧袋形瓣引导性骨再生手术患者,根据骨粉表面是否覆盖胶原膜分为胶原膜覆盖组和无覆盖组。术前(T0)、术后即刻(T1)和术后3~7个月(T2)拍摄锥形束CT,利用Mimics软件测量种植体光滑-粗糙交界面下不同水平(0、2、4和6 mm)处颊侧骨板厚度(thickness of the buccal bone plate,BBT,分别表示为BBT-0、-2、-4、-6)。结果:收集胶原膜覆盖组15例,无胶原膜覆盖组14例,共计29例患者进行统计分析。在T0、T1和T2三个时间点,不同水平的BBT在两组间差异均无统计学意义(P>0.05)。T2时,BBT-0在胶原膜覆盖组和无覆盖组分别为(1.22±0.55)mm和(1.70±0.97)mm,相应的BBT-2分别为(2.32±0.94)mm和(2.57±1.26)mm。T1~T2愈合阶段不同水平处颊侧骨板吸收的绝对值[(0.47±0.54)~(1.33±0.75)mm]和百分数[(10.04%±24.81%)~(48.43%±18.32%)],以及T0~T2阶段颊侧骨板新骨形成厚度[(1.27±1.09)~(2.75±2.15)mm]在两组间差异均无统计学意义。结论:颊侧袋形瓣引导骨再生手术无论是否使用胶原膜均可有效修复种植体颈部颊侧骨缺损。与无胶原膜覆盖相比,胶原膜覆盖植骨材料不能提高术后牙槽嵴轮廓的稳定性。展开更多
Periodontal tissue engineering involves a multi-disciplinary approach towards the regeneration of periodontal ligament,cementum and alveolar bone surrounding teeth,whereas bone regeneration specifically applies to rid...Periodontal tissue engineering involves a multi-disciplinary approach towards the regeneration of periodontal ligament,cementum and alveolar bone surrounding teeth,whereas bone regeneration specifically applies to ridge reconstruction in preparation for future implant placement,sinus floor augmentation and regeneration of peri-implant osseous defects.Successful periodontal regeneration is based on verifiable cementogenesis on the root surface,oblique insertion of periodontal ligament fibers and formation of new and vital supporting bone.Ultimately,regenerated periodontal and peri-implant support must be able to interface with surrounding host tissues in an integrated manner,withstand biomechanical forces resulting from mastication,and restore normal function and structure.Current regenerative approaches utilized in everyday clinical practice are mainly guided tissue/bone regeneration-based.Although these approaches have shown positive outcomes for small and medium-sized defects,predictability of clinical outcomes is heavily dependent on the defect morphology and clinical case selection.In many cases,it is still challenging to achieve predictable regenerative outcomes utilizing current approaches.Periodontal tissue engineering and bone regeneration(PTEBR)aims to improve the state of patient care by promoting reconstitution of damaged and lost tissues through the use of growth factors and signaling molecules,scaffolds,cells and gene therapy.The present narrative review discusses key advancements in PTEBR including current and future trends in preclinical and clinical research,as well as the potential for clinical translatability.展开更多
文摘目的:在颊侧袋形瓣引导性骨再生手术基础上,探讨放置可吸收胶原膜是否有利于维持术后牙槽嵴轮廓稳定。方法:收集2019年6月至2023年6月因单颗后牙缺失采用种植体植入同期进行颊侧袋形瓣引导性骨再生手术患者,根据骨粉表面是否覆盖胶原膜分为胶原膜覆盖组和无覆盖组。术前(T0)、术后即刻(T1)和术后3~7个月(T2)拍摄锥形束CT,利用Mimics软件测量种植体光滑-粗糙交界面下不同水平(0、2、4和6 mm)处颊侧骨板厚度(thickness of the buccal bone plate,BBT,分别表示为BBT-0、-2、-4、-6)。结果:收集胶原膜覆盖组15例,无胶原膜覆盖组14例,共计29例患者进行统计分析。在T0、T1和T2三个时间点,不同水平的BBT在两组间差异均无统计学意义(P>0.05)。T2时,BBT-0在胶原膜覆盖组和无覆盖组分别为(1.22±0.55)mm和(1.70±0.97)mm,相应的BBT-2分别为(2.32±0.94)mm和(2.57±1.26)mm。T1~T2愈合阶段不同水平处颊侧骨板吸收的绝对值[(0.47±0.54)~(1.33±0.75)mm]和百分数[(10.04%±24.81%)~(48.43%±18.32%)],以及T0~T2阶段颊侧骨板新骨形成厚度[(1.27±1.09)~(2.75±2.15)mm]在两组间差异均无统计学意义。结论:颊侧袋形瓣引导骨再生手术无论是否使用胶原膜均可有效修复种植体颈部颊侧骨缺损。与无胶原膜覆盖相比,胶原膜覆盖植骨材料不能提高术后牙槽嵴轮廓的稳定性。
基金supported by the University of Michigan Periodontal Graduate Student Research Fund.Giannobile WV was supported by NIH/NIDCR(U24.DE026915).
文摘Periodontal tissue engineering involves a multi-disciplinary approach towards the regeneration of periodontal ligament,cementum and alveolar bone surrounding teeth,whereas bone regeneration specifically applies to ridge reconstruction in preparation for future implant placement,sinus floor augmentation and regeneration of peri-implant osseous defects.Successful periodontal regeneration is based on verifiable cementogenesis on the root surface,oblique insertion of periodontal ligament fibers and formation of new and vital supporting bone.Ultimately,regenerated periodontal and peri-implant support must be able to interface with surrounding host tissues in an integrated manner,withstand biomechanical forces resulting from mastication,and restore normal function and structure.Current regenerative approaches utilized in everyday clinical practice are mainly guided tissue/bone regeneration-based.Although these approaches have shown positive outcomes for small and medium-sized defects,predictability of clinical outcomes is heavily dependent on the defect morphology and clinical case selection.In many cases,it is still challenging to achieve predictable regenerative outcomes utilizing current approaches.Periodontal tissue engineering and bone regeneration(PTEBR)aims to improve the state of patient care by promoting reconstitution of damaged and lost tissues through the use of growth factors and signaling molecules,scaffolds,cells and gene therapy.The present narrative review discusses key advancements in PTEBR including current and future trends in preclinical and clinical research,as well as the potential for clinical translatability.
