高純化第一型膠原蛋白應用於拔牙後窩洞癒合之評估:臨床試驗

有鑑於拔牙後骨質保存之重要性，隨著人工植牙之需求增加而被強調，有關拔牙後傷口之敷料或代用骨之置入日漸被重視，以高純化第一型膠原蛋白充填於拔牙後窩洞之結果仍不一致而有爭議。本研究之目的，以臨床試驗方式，仔細評估高純化第一型膠原蛋白是否能促進傷口癒合，並改善病人術後症狀，及促進骨質癒合。其方法為選取具雙側對稱阻生齒之病患30人，於拔除第三大臼齒後，一側放入高純化膠原蛋白敷料為實驗組，一側則不放入材料為對照組，並以序列性X光影像分析，牙周囊袋量測，疼痛、腫脹、開口度等臨床指標進行研究。結果顯示疼痛分數在實驗側平均為2.60±1.23分，對照側平均為4.65±2.01，其P值小於0.05，病人所感受之疼痛天數亦有明顯差異，而就受試者術後開口是否順暢，實驗側有11例 (55.0%)同意，對照側有2例 (10.0%)同意，其P值小於0.05，X光影像分析骨質量化密度結果顯示，實驗側比對照側在骨質量化密度的測量中好10.16%，統計上亦有顯著差異。拔牙後窩洞填充高純化第一型膠原蛋白敷料有助於減低術後疼痛，減少疼痛天數，促進開口順暢及促進骨質癒合。拔牙後置入高純化第一型膠原蛋白敷料有助於傷口癒合及減低術後不適，其可做為術後傷口之填充物應有其合理性及臨床意義。

關鍵字

高純化第一型膠原蛋白敷料；臨床試驗；雙側對稱阻生齒；疼痛；腫脹；牙周囊袋

並列摘要

Ridge preservation following tooth extraction was highly respected recently. Owing to successful implant treatment always correlated with good bone quality before surgery. Post extraction wound dressing and bone substitute were highlighted with above reasons. However, there was also controversial wound healing result of highly purified type I collagen in post extraction socket. The purpose of this investigation was to evaluate a highly purify type I collagen dressing in wound healing of bilateral impacted third molars post-extraction sockets. By means of clinical trial, questionnaire, clinical examination, and biostatistics to confirm the effect of post operation symptom relief and bone healing promotion .Thirty patients with bilateral symmetrical impacted third molars were enrolled in this study. One side with highly purified type I collagen was served as experiment side and the other side was served as control side without filling anything. Patients with highly purified type I collagen dressing filling side had lower visual pain scale score 2.60±1.23 than control side 4.65±2.01 and had discrepancy -2.05±1.76 with statistically significant. Patients with highly purified type I collagen dressing filling side had lower pain duration 2.70±1.38 days than control side 3.70±1.84 days and had discrepancy -1.00±1.97 with statistically significant. Patients with highly purified type I collagen dressing filling side up to 11 sites (55%) experienced no limitation of mouth opening comparing to control side only 2 sites(10.0%).Radiographic bone density analysis indicated that experiment side had better new bone formation ratio up to 10.16% than control side with statistically significant. In this study, implantation of highly purified type I collagen dressing in extraction sockets can raise life quality following surgery by relieving of pain, shorten of pain duration and reduction of open mouth limitation and promote bone healing with coincidence in statistically results. Results of this investigation inspired clinical dentists’ effort in raising life quality of post extraction patients and provided a good resolution to post extraction site bone healing and pre-implantation alveolar bone preparation.

並列關鍵字

highly purified type I collagen dressing ； clinical trial ； bilateral impacted third molar ； pain ； swelling ； periodontal pocket

參考文獻

Akesson, L., J. Hakansson, et al. (1992). "Comparison of panoramic and intraoral radiography and pocket probing for the measurement of the marginal bone level." J Clin Periodontol 19(5): 326-332.

Amler, M. H. (1969). "The time sequence of tissue regeneration in human extraction wounds." Oral Surg Oral Med Oral Pathol 27(3): 309-318.

Araujo, M. G., B. Liljenberg, et al. (2010). "beta-Tricalcium phosphate in the early phase of socket healing: an experimental study in the dog." Clin Oral Implants Res 21(4): 445-454.

Araujo, M. G. and J. Lindhe (2005). "Dimensional ridge alterations following tooth extraction. An experimental study in the dog." J Clin Periodontol 32(2): 212-218.

Araujo, M. G. and J. Lindhe (2009). "Ridge preservation with the use of Bio-Oss collagen: A 6-month study in the dog." Clin Oral Implants Res 20(5): 433-440.

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高純化第一型膠原蛋白應用於拔牙後窩洞癒合之評估:臨床試驗

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