CAJ | 학술논문

目的：本研究旨在通过动物实验观察并探讨种植体周围骨缺损剩余骨壁对骨缺损修复有无影响。建立小型猪即刻种植实验动物模型并依据实验设计确定剩余骨壁的厚度，后与骨壁相距一定距离植入种植体，实验组加入人工骨粉、自体骨碎末混合物并覆盖胶原膜，空白组只覆盖胶原膜，来比较观察种植体周围骨缺损剩余骨壁对骨缺损修复有无影响，以期为临床工作提供理论和实验依据。方法选取4只健康小型猪，雌雄各半。微创拔除左、右上颌第2、3、4前磨牙，后手术剥离龈瓣，充分暴露骨壁，并用高温高压灭菌后的游标卡尺一一测量其颊侧剩余骨壁的厚度。用裂钻磨除颊面达釉牙骨质界下约5 mm ，呈“U”字形骨缺损，并保证其颊面骨壁厚度分别为0．5mm、1mm和1．5mm，后分别植入种植体，并使种植体与颊侧骨壁相距3 mm。左侧为实验组，于缺损处加入人工骨粉、自体骨碎末混合物，后覆盖胶原膜，膜边缘覆盖超出骨缺损四周2 mm ，冠方平齐龈缘，龈瓣复位缝合；右侧设空白对照，植入种植体后直接缝合。术后8周，12周分别处死两只动物，取上颌骨，制取标本，进行肉眼观察、骨密度测量及种植体骨磨片观察。结果（1）肉眼观察，口腔卫生保持良好，未出现创口感染、裂开或种植体脱落现象。处死动物之前均无动物意外死亡情况发生。（2）骨密度测量结果显示，术后8周时实验组为（0．5899±0．0256），对照组为（0．4360±0．0507）；术后12周时实验组为（0．6189±0．0512），对照组为（0．5140±0．0386），不同时间点实验组与对照组的骨密度差异有统计学意义（P＜0．05）。（3）骨磨片观察，种植体周围骨壁厚度越厚成骨效果越好。结论种植体周围骨缺损剩余骨壁越厚其骨缺损修复效果越好。
목적：본연구지재통과동물실험관찰병탐토충식체주위골결손잉여골벽대골결손수복유무영향。건립소형저즉각충식실험동물모형병의거실험설계학정잉여골벽적후도，후여골벽상거일정거리식입충식체，실험조가입인공골분、자체골쇄말혼합물병복개효원막，공백조지복개효원막，래비교관찰충식체주위골결손잉여골벽대골결손수복유무영향，이기위림상공작제공이론화실험의거。방법선취4지건강소형저，자웅각반。미창발제좌、우상합제2、3、4전마아，후수술박리간판，충분폭로골벽，병용고온고압멸균후적유표잡척일일측량기협측잉여골벽적후도。용렬찬마제협면체유아골질계하약5 mm ，정“U”자형골결손，병보증기협면골벽후도분별위0．5mm、1mm화1．5mm，후분별식입충식체，병사충식체여협측골벽상거3 mm。좌측위실험조，우결손처가입인공골분、자체골쇄말혼합물，후복개효원막，막변연복개초출골결손사주2 mm ，관방평제간연，간판복위봉합；우측설공백대조，식입충식체후직접봉합。술후8주，12주분별처사량지동물，취상합골，제취표본，진행육안관찰、골밀도측량급충식체골마편관찰。결과（1）육안관찰，구강위생보지량호，미출현창구감염、렬개혹충식체탈락현상。처사동물지전균무동물의외사망정황발생。（2）골밀도측량결과현시，술후8주시실험조위（0．5899±0．0256），대조조위（0．4360±0．0507）；술후12주시실험조위（0．6189±0．0512），대조조위（0．5140±0．0386），불동시간점실험조여대조조적골밀도차이유통계학의의（P＜0．05）。（3）골마편관찰，충식체주위골벽후도월후성골효과월호。결론충식체주위골결손잉여골벽월후기골결손수복효과월호。
Objective The aim of this study is to through animal experiment to observe and study the peri implant bone defect residual bone wall has no effect on repairing bone defect .Establishment of miniature pig farming immediate experimental animal model and on the basis of experimental design to determine residual bone wall thickness ,and the bone wall after a certain distance of implant ,the experimental group joined the artificial bone ,autogenous bone powder mixture and covered with collagen membrane ,blank group covers only collagen membrane ,to compare observation of bone defects around implants residual bone wall for repairing bone defect has no effect ,in order to provide theoretical and experimental basis for the clinical work .Methods Select 4 healthy pigs ,male and female ,minimally invasive removal of left ,right upper second ,3 ,4 premolar ,after stripping gingival flap operation ,fully exposed bone wall ,and vernier caliper with high -pressure steam steril-ization after the one one measurement of the buccal residual bone wall thickness ,split drill grinding buccal sur-face up to the cemento enamel junction to about 5 mm ,a“U” shaped bone defect ,and ensure the cheek bone wall thickness are respectively 0 .5 mm ,1 mm and 1 .5 mm respectively after implantation ,implant ,the implant and the buccal bone wall away from the 3 mm ,on the left side as experimental group ,including the artificial bone ,autogenous bone powder and mixture on a defect after covering ,collagen membrane ,membrane edge cov-erage beyond the bone defect around 2 mm ,crown Fang Ping Qi gingival ,gingival flap reposition ,right control , direct suture implant .After 8 weeks ,1 2 weeks were two animal ,the maxilla ,preparation of specimens ,naked eye observation ,measurement of bone mineral density and bone implant disk observation .Results (1 )naked eye observation ,good oral hygiene ,no wound infection ,dehiscence or implant failure phenomenon .Death animal had no occurrence of accidental death of animal .(2 )bone density measurement results show that ,at 8 weeks af-ter operation the experimental group was(0 .5899 ± 0 .0256 ) ,control group was(0 .4360 ± 0 .0507 );12 weeks afteroperationtheexperimentalgroupwas(0 .6189 ±0 .0512),controlgroupwas(0 .5140 ±0 .0386),statisti-cally significant differences in bone density at different time points of the experiment group and the control group (P<0 .05 ) .(3 ) bone slices observation ,peri implant bone wall thicker osteogenic effect .Conclusion The bone defects around implants residual bone w all thicker bone repair effect .