CAJ | 학술논문

背景：慢性根尖周炎症导致根尖周骨质破坏及缺损并不少见，若不能及时消除炎症终止骨吸收和牙龈组织的破坏，修复根尖周组织缺损，最终将导致牙丧失。脱细胞真皮基质和珊瑚羟基磷灰石在动物实验中常用于修复牙周损伤。 　　目的：评价异体脱细胞真皮基质与珊瑚羟基磷灰石两种材料联合修复根尖周组织缺损的临床疗效。 　　方法：选择76例慢性根尖周炎患者作为研究对象，患者等分为实验组和对照组。实验组患者采用异体脱细胞基质与珊瑚羟基磷灰石联合修复根尖周组织缺损；对照组患者不植入任何材料。2组患者均行根尖切除及根尖倒充。修复后1周及6，12个月复诊，通过临床症状和 X射线片检查评价修复效果。 　　结果与结论：修复1个月后，实验组患者异体脱细胞真皮基质全部存活，因修整瘘管口周围炎性的肉芽组织导致的牙龈组织缺损已经愈合。在修复12个月后，实验组患者的修复有效率明显高于对照组(P <0.05)。实验组患者修复6个月后骨缺损区阴影基本消失，珊瑚羟基磷灰石颗粒间的透射影减小，出现有一定致密度的影像，提示有新骨长入；12个月后珊瑚羟基磷灰石颗粒密度已接近正常的骨组织密度，与正常骨组织之间有密度移行改变，逐渐与牙槽骨形成骨融合。异体脱细胞基质与珊瑚羟基磷灰石的生物相容性良好。提示异体脱细胞真皮基质与珊瑚羟基磷灰石联合修复根尖周组织缺损具有良好的临床疗效。
 　　배경：만성근첨주염증도치근첨주골질파배급결손병불소견，약불능급시소제염증종지골흡수화아간조직적파배，수복근첨주조직결손，최종장도치아상실。탈세포진피기질화산호간기린회석재동물실험중상용우수복아주손상。 　　목적：평개이체탈세포진피기질여산호간기린회석량충재료연합수복근첨주조직결손적림상료효。 　　방법：선택76례만성근첨주염환자작위연구대상，환자등분위실험조화대조조。실험조환자채용이체탈세포기질여산호간기린회석연합수복근첨주조직결손；대조조환자불식입임하재료。2조환자균행근첨절제급근첨도충。수복후1주급6，12개월복진，통과림상증상화 X사선편검사평개수복효과。 　　결과여결론：수복1개월후，실험조환자이체탈세포진피기질전부존활，인수정루관구주위염성적육아조직도치적아간조직결손이경유합。재수복12개월후，실험조환자적수복유효솔명현고우대조조(P <0.05)。실험조환자수복6개월후골결손구음영기본소실，산호간기린회석과립간적투사영감소，출현유일정치밀도적영상，제시유신골장입；12개월후산호간기린회석과립밀도이접근정상적골조직밀도，여정상골조직지간유밀도이행개변，축점여아조골형성골융합。이체탈세포기질여산호간기린회석적생물상용성량호。제시이체탈세포진피기질여산호간기린회석연합수복근첨주조직결손구유량호적림상료효。
Chronic periapical periodontitis often causes periapical tissue defects and ultimately leads to the loss of teeth if the inflammation is not promptly cleared to terminate bone resorption and destruction of gingival tissue. Acelular dermal matrix alograft and coraline hydroxyapatite are the common materials to repair periodontal injury. To evaluate clinical efficacy of acelular dermal matrix alograft combined with coraline hydroxyapatite in repairing periapical tissue defects. A total of 76 patients of chronic apical periodontitis were randomly divided into two groups, with 38 cases in each group. In the experimental group, periapical tissue defects were treated with acelular dermal matrix alograft and coraline hydroxyapatite. In the control group, tissue defects were not treated. Al the involved patients underwent apicectomy and retrograde filing. Clinical parameters and radiographic film were recorded at 1 week, 6 months and 3 years folow-up visits to evaluate the repairing effects. After 1 month of treatment, al acelular dermal matrix alografts survived, and the defect of gingival tissues that caused by repairing fistula had been healed. After 3 years, the repairing efficiency in the experimental group was significantly higher than that in the control group (P < 0.05). The bone defect disappeared in the experimental group at 6 months, the transmission of coraline hydroxyapatite particles was decreased, and there were some fuzzy images of compact density. This suggested that new bone was growing. The density of coraline hydroxyapatite particle got closed to normal bone tissue after 3 years, and there were transitional changes of density between coraline hydroxyapatite with normal bone. Coraline hydroxyapatite particle gradualy fused with alveolar bone. Acelular dermal matrix alograft and coraline hydroxyapatite have good biological compatibility. In repairing periapical tissue defects, the application of acelular dermal matrix alograft combined with coraline hydroxyapatite is effective in clinical practice.