80中国口腔种植学杂志2010年第15卷第2期异种脱细胞真皮基质修复骨引导再生术后软组织缺损的临床观察李玲慰胡晓文李斯日古楞李翠君商要l目的：观察异种脱细胞真皮基质在骨引导再生术中充当屏障膜并直接修复术后软组织不足的临床效果及对引导骨再生的影响。方法：选择在中山大学附属口腔医院种植科要求种植修复治疗，但因种植区牙槽嵴萎缩，宽度不足而需先行骨引导再生术的患者7例(其中女性5例，男性2例，平均34岁)，术中用脱细胞真皮基质覆盖骨引导再生区域，并直接修补创面软组织不足，临床观察脱细胞真皮基质愈合情况。通过影像学和临床检查评价新生的引导再生骨。结果：术后2周可见创面生物膜有部分降解，骨移植材料表面有薄层胶原基质覆盖；术后3周，创面开始有少量牙龈上皮覆盖；术后4周，牙龈上皮覆盖全部创面，与周围牙龈融合。术后1年，牙种植手术中见再生骨质量好，缺牙区牙槽嵴宽度明显增宽。影像学检查显示，随愈合时间延长，骨粉颗粒高密度影像逐渐消失，与周围正常骨质问界限不清。结论：脱细胞真皮基质充当骨引导生物膜并同时修复骨增量术后软组织不足的临床效果满意。【关键诩脱细胞真皮基质(acellulardermalmatrixADM)；软组织不足；骨增量术；骨引导再生(guidedboneregenerationGBR)中图分类号：R782．2文章标识码：A文章编号：1007—3957(2010)15—80一O5ClinicalobservationofrepairingsofttissuedefectwiththeacellulardermalmatrixinguidedboneregenerationsurgeryLILingwei，HUXiaowen，Llsiriguleng，etalImplantologyDepartment．GuanghuaSchoolofStomatologySunYat—enUniversity．510060Ah~traetObjective：ToobservetheclinicaleffectsofusingtheacellulardermalmatrixfADM1asbarriermembraneandfordirectlyrepairingsofttissuedefectintheguidedboneregenerationsurgerymean-whileandtheeffectsoftheprocedureontheformingoftheguidedregenerativebone．Methods：7pa—tients(5female，2male，averagedage：34yearsold)requiringimplantrestorationintheImplantDe—partment，GuanghuaSchoolofStomatologySunYat-senUniversity，wereincludedintheanalysis．Allpatientshadguidedboneregenerationsurgeryperformedpriortoimplantsurgeryduetosevereatrophicalveolarridgesandinadequatewidthoftheindicatedalveolarcrests．Acellulardermalmatrixwasap—pliedtocovertheguidedregenerativefieldandmeanwhiledirectlytorepairsofttissuedefectinthesurgery．ThehealingconditionofADMwasclinicallyobserved．Thenewguidedregenerativebonewasassessedradiographicallyanddeterminedintheimplantsurgeryclinically．Results：At2weekaftersurgery，thedegradationofADMoccurredtosomeextentandathinlayerofcollagenmatrixofADMonthesurfaceofbonesubstituteswerefound．At3weekaftersurgery，someofepithelialcellscoveringthesurgicalareawereobserved．At4weekfollowingsurgery，thenewbornepithelialcellsalmostoccupied作者单位：510060中山大学光华口腔医学院附属口腔医院种植科。通讯作者：胡晓文中国口腔种植学杂志2010年第15卷第2期thewholewoundareaandweremergedwiththesurroundinggingiva1．Duringimplantsurgeryat1yearaftertheguidedsurgery，fineregenerativeboneandapparentlywidealveolarcrestintheedentulousareawereobserved．Radiographicexaminationshowedthatashealingtimegoeson，thehigedensitiveimagesfromparticlesofbonesubstitutedisappearedgradually．Theboundarybetweenthebonesubsti—tutesandsurroundingnormalbonewasunclear．Conclusion：TheclinicaloutcomesweresatisfiedthatADMwasusedasbone——guidedbiologicalmembraneanddirectlyusedtorepairsofttissuedefectafteralveolaraugmentationsurgery．Keywords：acellulardermalmatrix(ADM)；softtissuedefect；boneaugmentationsurgery；guidedboneregeneration(GBR)牙缺失患者往往会伴有不同程度的牙槽骨缺损或萎缩，这常导致种植区可用骨宽度和高度不足。牙种植外...
