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一种新型合成可吸收牙科膜的临床安全性:病例系列研究

Clinical Safety of a New Synthetic Resorbable Dental Membrane: A Case Series Study.

作者信息

Martin-Thomé Hélène, Bourdin David, Strube Nicolas, Saffarzadeh Afchine, Morlock Jean-Francois, Campard Guillaume, Evanno Charles, Hoornaert Alain, Layrolle Pierre

机构信息

1   Dental Practice, Cesson-Sévigné, France.

2   Solea Dental Practice, Cholet, France.

出版信息

J Oral Implantol. 2018 Apr;44(2):138-145. doi: 10.1563/aaid-joi-D-17-00042. Epub 2018 Jan 5.

Abstract

Dental membranes are commonly used in oral and maxillofacial surgery for the regeneration of small osseous defects. A new synthetic resorbable membrane has recently demonstrated its biocompatibility and bone regeneration capacity in preclinical studies. This membrane is made of poly(D,L-lactic/glycolic acid 85/15), has a bi-layered structure with a dense film to prevent gingival epithelial cell invasion, and a microfibrous layer to support osteogenic cells and bone healing. This membrane completely degrades by hydrolysis in 4 to 6 months without signs of inflammation. Based on this research, a clinical study was conducted to evaluate the safety of the new membrane in guided tissue regeneration (GTR). In total, 26 patients (age: 50.5 ± 12.4, min-max 31-72 years; male/female 42/58%) were operated on at 7 independent private dental practices. Dental surgeons used the membrane together with various bone fillers in GTR for immediate and delayed implant placement (23 cases, 88%) and, to a lesser extent, socket preservation (2 cases, 8%) and alveolar crest augmentation (1 case, 4%). Surgeons reported an easy placement of the membrane (satisfaction index: 3.8/5). Fourteen days postsurgery, 15 patients had no pain while the others declared minimal pain (verbal rating scale: 2.2/10), and none had minor or serious complications related to the membrane. Exposure of the membrane without loosening the biomaterial granules was observed in 3 cases while mucosa healed normally over time. At 4 months postimplantation, no infection or mucosal inflammation was reported, and the overall dentist satisfaction with the clinical performance of the membrane was 4.5/5 on average. This clinical study demonstrated that the new synthetic resorbable membrane is safe for guided bone tissue regeneration in various dental surgery indications.

摘要

牙膜常用于口腔颌面外科手术中,以促进小骨缺损的再生。一种新型合成可吸收膜最近在临床前研究中证明了其生物相容性和骨再生能力。这种膜由聚(D,L-乳酸/乙醇酸85/15)制成,具有双层结构,其中致密膜可防止牙龈上皮细胞侵入,微纤维层可支持成骨细胞和骨愈合。这种膜在4至6个月内通过水解完全降解,无炎症迹象。基于这项研究,开展了一项临床研究,以评估这种新型膜在引导组织再生(GTR)中的安全性。共有26名患者(年龄:50.5±12.4岁,最小-最大年龄31-72岁;男性/女性比例为42/58%)在7家独立的私人牙科诊所接受了手术。牙科外科医生在GTR中使用该膜与各种骨填充剂一起进行即刻和延期种植体植入(23例,88%),在较小程度上用于牙槽窝保存(2例,8%)和牙槽嵴增高(1例,4%)。外科医生报告称该膜易于放置(满意度指数:3.8/5)。术后14天,15名患者无疼痛,其他患者称疼痛轻微(视觉模拟评分:2.2/10),且无一例出现与该膜相关的轻微或严重并发症。3例患者观察到膜暴露,但生物材料颗粒未松动,同时黏膜随时间正常愈合。种植后4个月,未报告感染或黏膜炎症,牙科医生对该膜临床性能的总体满意度平均为4.5/5。这项临床研究表明,这种新型合成可吸收膜在各种牙科手术适应症中用于引导骨组织再生是安全的。

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