摘要
目的探讨下颌阻生第三磨牙拔除后,第二磨牙牙周骨质缺损及其自体骨移植的修复效果。方法选择下颌阻生第三磨牙拔除病例70例,年龄(29.1±2.6)岁,分为观察组33例和对照组37例。术前,MCT测量第二磨牙牙周骨质缺损。观察组在术区暴露的外斜线切取自体骨,移植在第二磨牙根面骨质缺损处;对照组对于第二磨牙牙周骨质缺损不做处理,任其自然愈合。术后3个月随访,MCT测量第二磨牙牙周的新骨生长。结果术前,观察组及对照组第二磨牙骨质缺损分别为(8.998 5±2.410 1)mm和(9.907 6±2.256 8)mm,差异无统计学意义(P>0.05)。术后3个月,观察组及对照组第二磨牙牙周新骨生长分别为(8.860 9±2.344 2)mm和(3.217 3±1.282 0)mm,骨再生率分别为98.47%和32.47%,两组新骨生长差异有统计学意义(P<0.05)。结论 MCT检查可以精确直观了解下颌第三磨牙拔除后,第二磨牙牙周骨质缺损及其修复情况。在拔除阻生下颌第三磨牙时,切取外斜线自体骨,无需扩大伤口、增加创伤。移植自体骨可以促进或加速第二磨牙术后牙周骨质缺损的修复。
Objective To investigate the periodontal bone defect of the 2 ndmolar with Micro-CT,as well as the effect of repairing bone defects with the autogenous bone obtained from the external oblique line of the mandible,following the extraction of the lower 3 rdmolar. Methods Seventy cases of the extraction of the lower 3 rdmolar were divided into two groups,experimental group（ n = 33） and control group（ n = 37）. The mean age was 29. 1 ± 2. 649 3 years. Before the surgery,patients＇ periodontal defects of their 2 ndmolars were measured by MCT. During the surgery,after extracting the lower 3 rdmolar,the bone grafts were obtained from the external oblique line of the mandible and transplanted into the periodontal defects of the 2 ndmolar in the experimental group,whereas the periodontal defects were left untreated in the control group. Three months after the surgery,the bone regenerations of the periodontal defects of the 2 ndmolar were measured by MCT. Results Before the surgery,periodontal defects of the 2 ndmolar were 8. 998 5 ± 2. 410 1 mm in the experimental group and 9. 907 6 ± 2. 256 8 mm in the control group,with no significant difference. Three months after the surgery,the bone regenerations were 8. 860 9 ± 2. 344 2 mm in experimental group and 3. 217 3 ± 1. 28 2 mm in control group,while the percentages of the bone regeneration were 98. 47% and 32. 47%,respectively. The difference of the bone regenerations was with statistical significance. Conclusion The periodontal bone defects of the 2 ndmolar and the bone regenerations can be detected precisely and visualized with t MCT,following the extraction of the lower 3 rdmolar.Besides,during the extraction,it would not be necessary to cause greater incisions or traumas when obtaining the bone graft from the external oblique line of the mandible. The bone regenerations of the periodontal defects of the 2 ndmolar could be improved and accelerated by transplanting the autogenous bone graft,following the extraction of the lower 3 rdmolar.
作者
许竞
张志勇
XU Jing;ZHANG Zhi - yong(Stomatological Hospital, Southern Medical Universit;Guangdong Provincial Stomatological Hospital, Guangzhou 510280, Guangdong , China)
出处
《广东医学》
CAS
2018年第11期1663-1666,1670,共5页
Guangdong Medical Journal
基金
广东省科技计划项目(编号:2013B021800166)
关键词
下颌阻生第三磨牙
拔牙
第二磨牙
牙周骨质缺损
自体骨
骨移植
impacted lower third molar
tooth extraction
second molar
periodontal defect
autogenous bone
bone transplantion.
