- 期刊
使用dPTFE再生膜以不翻瓣進行骨脊保存術之病例系列報告
Flapless Alveolar Ridge Preservation with dPTFE Membrane: A Case Series
摘要
骨脊型態在拔牙後會發生改變，剩餘骨體積常無法依良好的贗復位置放置甚至無法提供植牙。骨脊保存術已證明有助於拔牙傷口癒合後骨體積之維持，且隨著材料的進步，給予了不同的手術方式更多可能性。dPTFE再生膜常被應用於開放式骨脊保存手術，提供了隔絕口腔微生物更好的屏障，同時免去皮瓣減張以達到傷口初級閉合所帶來的傷口不適，唯皮瓣翻開對於手術之負面影響仍不能忽略。本篇病例系列報告提出三例面臨拔牙之患者，以dPTFE再生膜與FDBA人工骨粉施予不翻瓣骨脊保存術（flapless alveolar ridge preservation），觀察6個月皆獲得良好的骨保存效果並得以順利植牙。研究目的：本篇系列報告提出三例以dPTFE再生膜與FDBA人工骨粉施予不翻瓣骨脊保存術。材料與方法：在不翻開皮瓣的情形下，以器械剝離拔牙窩洞周圍牙齦與齒槽骨之附連，填補骨粉後將剪裁適當大小的dPTFE再生膜插入牙齦下使之覆蓋於拔牙窩洞與骨缺損處。結果：本篇之三案例於6個月後皆獲得良好的骨保存效果並得以順利植牙。結論：使用dPTFE再生膜以不翻瓣的方式進行骨脊保存術，在操作簡單、侵入性低的情形下得以達到良好的骨保存效果，且於術後6個月順利完成植牙，顯示使用此法可成為術式選項之一，唯未來仍需更多的後續研究。
並列摘要
Without any treatment during tooth extraction, alveolar ridge absorption and loss of soft and hard tissue are unavoidable results, which will cause difficulties in subsequent rehabilitation and dental implant placement. Alveolar ridge preservation has been proved to preserve ridge volume after tooth extraction. Dense-polytetrafluoroethylene membrane was often used for open membrane technique, since it was given the advantages of low-porosity as bacteria barrier, avoiding the patient from post-surgical discomfort caused by tension release and primary wound closure. However, the negative impact of flap elevation to the treatment outcome cannot be neglected. This case series reported 3 patients with hopeless tooth treated by flapless alveolar ridge preservation with dPTFE membrane and FDBA. All cases showing satisfying ridge dimension and were capable for prosthetic-driven implant placement after 6 months. Materials and Methods: Atraumatic extraction was performed followed by detachment of the soft tissue from alveolar bone by blunt dissection around the socket. After placing the bone graft, a trimmed dPTFE membrane was placed upon the bone graft and the edge of it was inserted into the detached space. Results: All 3 cases showing satisfying ridge dimension and were capable for prosthetic-driven implant placement after 6 months without the need for extra bone augmentation. Conclusion: This case series showed a promising result as an easy and conservative method for alveolar ridge preservation.