自体骨联合异种骨移植材料对牙列缺损患者术后骨吸收及种植体存留的影响

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　　 【摘要】 目的：探讨对牙列缺损患者行异种骨联合自体骨移植效果。方法：选取2016年1月-2017年
　　4月就诊于本院的84例牙列缺损患者，按随机数字表法分为试验组和对照组，每组42例。试验组行异种骨、自体骨联合移植，對照组行异种骨移植。比较两组植骨面积与骨吸收率、X线影像检查结果、术后不良反应、牙齿松动度、种植体残留等情况。结果：两组术后即刻植骨面积比较，差异无统计学意义（P>0.05），试验组术后2年时植骨面积明显小于对照组，差异有统计学意义（P<0.05）。试验组牙槽骨吸收、牙根吸收正常率均高于对照组，且牙周膜影像优于对照组，差异均有统计学意义（P<0.05）。术后，两组各出现1例种植体感染，抗感染治疗后再次行种植体修复，恢复效果良好。试验组术后牙齿松动度与对照组相比较低，差异有统计学意义（P<0.05）。试验组种植体残留率与对照组相比，差异无统计学意义（P>0.05）。结论：对牙列缺损患者行自体骨联合异种骨移植安全性、种植体残留率与单一异种骨移植相似，而前者可有效减小植骨面积，减小牙齿松动度，促进牙槽骨与牙根吸收，利于重建牙周膜，但术后骨吸收较高。
　　 【关键词】 牙列缺损 自体骨 异种骨 种植体存留 骨吸收
　　 Effect of Autologous Bone Combined with Xenograft Bone Graft on Postoperative Bone Resorption and Implant Retention in Patients with Dentition Defect/ZHANG Yan， FAN Haidong， WANG Qiuxia， SONG Guojun. //Medical Innovation of China， 2020， 17（11）： 0-056
　　 [Abstract] Objective： To investigate the effect of heterogeneous bone combined with autologous bone graft in patients with dentition defect. Method： A total of 84 patients with dentition defects who were admitted to our hospital from January 2016 to April 2017 were enrolled. The patients were divided into two groups according to the random number table， 42 cases in each group. The experimental group was treated with xenogenic bone and autologous bone transplantation， the control group was treated with xenograft. The bone graft area and bone resorption rate， X-ray imaging results， postoperative adverse reactions， tooth looseness， and implant residuals were compared.
　　Result： The immediate bone graft area was compared between the two groups， there was no statistical significance （P>0.05）. The bone grafting area of ??the experimental group was significantly lower than that of the control group at 2 years after operation （P<0.05）. The normal rate of alveolar bone resorption and root resorption in the experimental group were higher than those in the control group， the periodontal ligament image in the experimental group was superior than that of the control group， the differences were statistically significant （P<0.05）. After the operation， 1 case of implant infection occurred in each group， after the anti-inflammatory treatment， the implant was repaired again， and the recovery effect was good. The degree of tooth loosening in the experimental group was lower than that in the control group， the difference was statistically significant （P<0.05）. There was no significant difference in the residual rate of the implant in the experimental group compared with the control group （P>0.05）. Conclusion： The safety and implant residual rate of autologous bone combined with xenograft in patients with dentition defect are similar to those of single xenograft. The former can effectively reduce bone grafting area， reduce tooth loosening and promote alveolar bone and root resorption. It is beneficial to reconstruct the periodontal ligament， but the postoperative bone resorption is higher.
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