發(fā)布時間：2018-03-24 03:23

  本文選題：骨缺損　切入點：骨填充材料　出處：《青島大學》2017年碩士論文

【摘要】：目的:富含β-磷酸三鈣(β-TCP)的骨填充材料與Bio-Oss骨填充材料做對比分析,評價富含β-磷酸三鈣的骨填充材料的臨床療效和安全。方法:本研究選取在青島大學附屬醫(yī)院就醫(yī)的拔牙患者40例,所選患者為18-70歲之間,有前牙或者前磨牙疾患需要拔除,口腔衛(wèi)生狀況良好,無全身系統(tǒng)性疾病。經(jīng)統(tǒng)一研究員對受試者對患者進行口腔�？茩z查和血液檢查,篩選入組患者。本實驗采取雙盲實驗方法。將患者隨機分為試驗組和對照組,試驗組采用富含β-磷酸三鈣的骨填充材料,對照組采用瑞士Geistlich公司的Bio-Oss骨填充材料。對經(jīng)過篩檢入組的患者進行患牙拔除術并在拔牙窩植入對應骨粉,拔牙窩雙層明膠海綿覆蓋,拉攏縫合牙齦,術后即刻拍CT記錄牙槽嵴的高度和寬度以及CT值,觀察兩組骨填充材料的安全性:1周復診拆線,觀察黏膜愈合狀況;拔牙創(chuàng)有無出現(xiàn)骨粉脫落,術后6個月復診拍CT測量牙槽嵴的高度和寬度以及CT值。將拔牙后即刻CT與拔牙后六個月之間的CT數(shù)據(jù)進行比較,觀察其有效性。計算出牙槽嵴垂直向骨吸收量和頰舌向骨吸收量。進一步分析試驗組與對照組的統(tǒng)計學差異,觀察試驗組骨填充材料與對照組骨填充材料的有效性和安全性的差異。結果:1.口腔內(nèi)臨床檢查40位受試者牙齦生長狀況良好,試驗組與對照組術后24小時大部分患者疼痛為Ⅰ級疼痛,疼痛程度不明顯。試驗組有2位患者出現(xiàn)II級疼痛,對照組患者有3位患者出現(xiàn)II級疼痛。試驗組和對照組共40例患者拔牙創(chuàng)等級都為甲級愈合,未有乙級愈合或丙級愈合的患者。試驗組和對照組患者拔牙創(chuàng)愈合時間大部分都在7天以內(nèi),大于7天的患者,實驗組2人,對照組1人,受試者均未出現(xiàn)感染、過敏等嚴重不良反應,術后一周復診均未出現(xiàn)術區(qū)感染,骨粉脫落等情況。實驗組和對照組均未發(fā)生不良事件。術后六個月拔牙窩處牙槽骨豐滿未有骨嵴骨棱出現(xiàn)。試驗組與對照組安全性對比P0.052.CT觀察及CT測量值。CT可見實驗組和對照組患者的成骨效果均很好。試驗組與對照組骨吸收的平均距離在水平方向在1.9mm左右,垂直方向在1mm左右。CT值在900-1000左右。術前術后試驗組與對照組骨吸收量無明顯差異P0.05,同一時間段試驗組與對照組CT值均數(shù)相近,同一時間段兩組數(shù)據(jù)比較P值0.05,試驗組與對照組數(shù)據(jù)無統(tǒng)計學差異,但同組患者的術后6個月CT值高于術后即刻CT值,P0.05。試驗組與對照組無明顯差異。結論:在拔牙窩骨缺損中,將富含β-磷酸三鈣骨填充材料與瑞士Geistlich公司的Bio-Oss骨填充材料對比,骨缺損區(qū)軟硬組織生長狀況及兩者六個月的成骨效果和骨吸收量無明顯差異。其療效和安全性與瑞士Geistlich公司的Bio-Oss骨填充材料相當。
[Abstract]:Objective: to compare the 尾 -TCP-rich bone filling material with Bio-Oss bone filling material. To evaluate the clinical efficacy and safety of bone filling materials rich in 尾 -tricalcium phosphate. Methods: forty patients with extraction of teeth were selected from Qingdao University affiliated Hospital. The selected patients were between 18 and 70 years of age. The patients with anterior teeth or premolar diseases needed to be removed. The oral hygiene condition is good, there is no systemic disease of the whole body. The patients were randomly divided into two groups: the experimental group and the control group. The patients in the experimental group were filled with bone filled with 尾 -tricalcium phosphate (尾 -tricalcium phosphate). The patients in the control group were treated with Bio-Oss bone filling material from Geistlich Company of Switzerland. The patients in the screening group were treated with extraction of the affected teeth and the corresponding bone powder was implanted in the extraction nest. The double layer gelatin sponge was used to cover the extraction nest and the gingiva was closed and sutured. The height, width and CT value of alveolar ridge were recorded by CT immediately after operation. The safety of bone filling materials in the two groups was observed. The height and width of alveolar ridge and CT value were measured 6 months after operation. Ct data were compared between immediately after extraction and 6 months after extraction. The vertical bone resorption and buccal bone resorption of alveolar ridge were calculated. The statistical difference between the experimental group and the control group was further analyzed. The efficacy and safety of bone filling materials in the experimental group and the control group were observed. Results the gingival growth status of 40 subjects with clinical examination in oral cavity was good. 24 hours after operation, most of the patients in the trial group and the control group had pain of grade 鈪，

本文編號：1656505