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两种不同可吸收膜覆盖上颌窦提升侧骨切开部位的比较:一项初步研究。

Comparison of two different absorbable membranes for the coverage of lateral osteotomy sites in maxillary sinus augmentation: a preliminary study.

机构信息

Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Kiel, Germany.

出版信息

J Craniomaxillofac Surg. 2013 Jan;41(1):76-82. doi: 10.1016/j.jcms.2012.10.015. Epub 2012 Dec 5.

Abstract

INTRODUCTION

Barrier membranes, both absorbable and non-absorbable, have been used in sinus augmentation for many years. Some years ago, a new autologous blood substrate called Platelet-Rich-Fibrin (PRF) was introduced, and to date, the supporting effect on bone regeneration has been controversial. This study aimed to evaluate the effect of PRF on bone regeneration when used as a barrier membrane at the lateral osteotomy site in sinus augmentation.

MATERIAL AND METHODS

Twelve sinuses from six patients requiring bilateral sinus floor augmentation were treated with a two-stage surgical technique using sinus augmentation and implant placement after 5 months. The sinuses were grafted with autologous bone and bone-substitute material (Bio-Oss(®)) mixed in a 1:1 ratio and were covered in a randomized split-mouth design with a PRF or a conventional collagen membrane (Bio-Gide(®)), respectively. Five months later threaded titanium dental implants were inserted and bone specimens harvested with a trephine burr were evaluated histomorphometrically.

RESULTS

Bone quality seemed to be equal at both sites of the grafted sinuses. Mean vital bone formation after 5 months was 17.0% and 17.2%, for the PRF and collagen sites, respectively. The mean of residual bone-substitute was 15.9% and 17.3% for PRF and collagen, respectively. No local complications, such as dehiscences or membrane exposures, were detected at either site in any of the treated patients. After 12 months all implants reached primary stability in the augmented maxillary sinus floor without any peri-implant tissue inflammation.

CONCLUSIONS

Within the limits of the study the coverage of the lateral sinus window with two different absorbable membranes has been shown to result in a similar amount of vital bone formation and residual bone-substitute.

摘要

简介

多年来,可吸收和不可吸收的屏障膜已被用于鼻窦提升术。几年前,一种新的自体血液基质被称为富血小板纤维蛋白(PRF)被引入,迄今为止,其对骨再生的支持作用仍存在争议。本研究旨在评估在鼻窦提升术外侧骨切开部位用作屏障膜时 PRF 对骨再生的影响。

材料和方法

6 名需要双侧鼻窦底提升的患者的 12 个鼻窦采用两阶段手术技术进行治疗,使用鼻窦提升和植入物放置,5 个月后进行。鼻窦用自体骨和骨替代物(Bio-Oss®)以 1:1 的比例混合进行移植,并在随机分侧设计中分别用 PRF 或常规胶原膜(Bio-Gide®)覆盖。5 个月后,插入螺纹钛牙科植入物,并使用环钻采集骨标本进行组织形态计量学评估。

结果

移植鼻窦的两个部位的骨质量似乎相等。5 个月后,PRF 和胶原部位的活骨形成率分别为 17.0%和 17.2%。PRF 和胶原的残留骨替代物的平均值分别为 15.9%和 17.3%。在任何接受治疗的患者中,在任何部位均未检测到局部并发症,如裂开或膜暴露。12 个月后,所有植入物在没有任何种植体周围组织炎症的情况下在增强的上颌窦底均达到了初始稳定性。

结论

在本研究的范围内,用两种不同的可吸收膜覆盖鼻窦外侧窗已显示出相似数量的活骨形成和残留的骨替代物。

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