中国实用口腔科杂志

中国实用口腔科杂志

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天然煅烧骨粉与碱性成纤维细胞生长因子联合对牙周骨缺损修复作用研究

陈铁楼a，张新海a，秦卫民a，王晓曼a，江一峰a，任正波a，王琦a，唐大海b   

  1. 海军军医大学第一附属医院精准医学中心，全军口腔中心a牙周科，b检验科，上海  200081
  • 出版日期:2018-04-15 发布日期:2018-04-17
  • 基金资助:

    上海市卫计委科研课题资助项目（20134418）；解放军总后勤部面上项目（CHJ13J035）

  • Online:2018-04-15 Published:2018-04-17

摘要：

目的    探讨天然煅烧骨粉（calcined natural bovine bone，CBB）植骨术和CBB植骨联合碱性成纤维细胞生长因子（basic fibroblast growth factor，bFGF）对牙周骨缺损修复作用和疗效。方法    选择2016年2—6月于海军军医大学第一附属医院全军口腔中心就诊，符合纳入条件的重症牙周炎患者10例（8例慢性牙周炎和2例侵袭性牙周炎）作为研究对象。在完成牙周基础治疗1个月后，对10例牙周炎患者的20个骨下袋分别行CBB植骨术（CBB组）和CBB植骨联合bFGF治疗（CBBbF组），在术前及术后6、12个月分别测定两组菌斑指数（plaque index，PI）、出血指数（bleeding index，BI）、牙周袋深度（probing depth，PD）、临床附着丧失（clinical attachment loss，CAL），并测定两组影像学差异。结果    CBBbF组术后1个月牙龈组织愈合良好者所占比率（90%）优于CBB组（40%），术后12个月时骨缺损区骨充盈明显增强者所占比率（90%）大于CBB组（60%）。两组在术后6、12个月时的BI、PD和CAL均比术前明显减少（P < 0.05），CBBbF组在术后6、12个月时BI、PD、CAL改善程度明显优于CBB组（P < 0.05）。两组在术后6、12个月时骨缺损区充盈程度均比术前明显增加，CBBbF组在术后6、12个月时骨充盈程度优于CBB组。结论    CBB骨移植与CBB植骨联合bFGF修复牙周骨缺损均有良好临床疗效，后者疗效优于前者。

关键词: 天然煅烧骨粉, 碱性成纤维细胞生长因子, 牙周骨缺损, 胶原, 骨移植

Abstract:

Objective    To investigate the biological effects of calcined natural bovine bone（CBB）and the effect of combination therapy for periodontal intrabony defects with CBB and basic fibroblast growth factor（bFGF）. Methods    Totally 10 cases of  severe periodontitis（8 cases of chronic periodontitis and 2 cases of aggressive periodontitis）were selected from February to June 2016 in Stomatological Center of CPLA，the First Affiliated Hospital of Naval Military Medical University. After 1 month of initial periodontal therapy，20 periodontal intrabony bone defects of 10 cases were treated with CBB bone grafting（group CBB，10 defects）or CBB combined with bFGF（group CBBbF，10 defects）. The patients were evaluated for plaque index（PI），bleeding index（BI），probing depths（PD）and clinical attachment loss（CAL）before the treatment and at 6 months and 12 months after surgery. The difference in bone filling was also determined. Results        The percentage of gingival tissue healing well at 1 month after operation in group CBBbF（90%）was better than that in group CBB（40%）. At 12 months，the percentage of good bone filling in bone defect area in group CBBbF（90%）was larger than that in group CBB（60%）. Both in group CBB and group CBBbF，BI，PD and CAL were significantly decreased at 6 and 12 months after operation compared with before operation（P < 0.05）. At 6 or 12 months after operation，the improvement of BI，PD，CAL in CBBbF group was significantly better than that in CBB group（P < 0.05）. In group CBB and group CBBbF，the degree of bone filling increased significantly at 6 and 12 months after operation than before operation. The degree of bone filling in group CBBbF was better than that in group CBB at 6 or 12 months. Conclusion    CBB bone graft and CBB combined with bFGF for repair of periodontal bone defect have good clinical effects，and the latter is better than the former.

Key words: calcined natural bovine bone, basic fibroblast growth factor, periodontal intrabony defects, collagen, bone grafts