摘要： 目的：临床观察阻生齿拔除术同期植入自体骨与人工骨粉混合物联合可吸收膜覆盖，对相邻磨牙远中牙周情况的影响。方法：挑选24例25～45岁，下颌第三磨牙近中低位阻生或水平阻生患者，研究组接受拔除术同期植骨术，对照组仅接受阻生齿拔除术。术后6月后询问患者主观感觉，牙周探诊检查探诊深度；全景片观察牙槽骨密度；CBCT观察相邻磨牙远中牙槽骨高度变化。两组间比较采用SAS软件进行t检验。结果：术后6月，研究组感觉不适者1例，无明显异常者11例，对照组患者感觉冷热刺激不适者9例，无明显异常者3例。第二磨牙远中牙周深度探诊结果为实验组（2.92±0.90） mm，对照组（3.00±1.35） mm，P值为0.86，差异无统计学意义。X线检查结果显示远中牙槽骨骨密度，研究组为129.42±7.81，对照组为121.82±9.44，P值为0.042 9，差异有统计学意义。CBCT结果示研究组牙槽骨高度增加（4.07±0.91） mm，对照组牙槽骨高度增加（2.38±1.09） mm，P<0.01。结论：阻生齿拔除同期植入自体骨与人工骨粉混合物，并用可吸收膜覆盖，能有效减轻低位阻生齿拔除后牙槽骨的吸收，并促进远中硬组织的形成，增加临床附着，减少术后第二磨牙远中根面暴露引起的牙周疾病，有助于患牙相邻磨牙牙周组织长期稳定。

关键词: 阻生齿, 牙槽骨吸收, 引导骨组织再生术

Abstract: Objective: The present study aimed to observe the influence of xeograft of mixture of autologous and artificial bone powder plus an absorptive membrane on the alveolar bone regeneration of odontectomized wisdom tooth sockets.  Methods：24 mesial impacted third molar were selected to experimental or control group according to randomization principle. The extraction socket was grafted with mixture of autologous and artificial powder plus a membrane. Probing depth level (PDL), bone density (BD) and bone gain (BG) were evaluated by probing, X ray, and CBCT respectively at 6 months post-operation; t test was made between groups via SAS software. Results: Only one case in experimental group felt hot and cold stimulation pain and nine cases felt that pain in the control group; the PDL was (2.92±0.90) mm in experimental group and (3.00±1.35) mm in the control group respectively(P=0.8603); the BD was 129.42±7.81 in the experimental group and 121.82±9.44 in the control group respectively(P=0.0.0429); bone gain of experimental group was (4.07±0.91) mm, higher than (2.38±1.09) mm of the control, P<0.01. Conclusion: Graft of autologous bone and artificial bone powder mixture plus absorbable membrane in the same period of third molar extraction, can decrease the distal alveolar loss of second molar after impacted third molar extraction, enhance bone gain, and clinical attachment level, thus reduce the risk of caries and periodontal disease, and helps to develop long-term stability of adjacent molar’s periodontal tissue.

Key words:  impactedtooth, alveolar resorption, guided bone tissue regeneration

中图分类号: 

• R782.11