上顎前歯部インプラントと同時期のガイド下骨再生（バイオガイドコラーゲン膜＋バイオOSS骨粉）の骨増生に及ぼす切開設計の違いによる影響

Influence of different incision designs on bone increment of guided bone regeneration (Bio-Gide collagen membrane +Bio-OSS bone powder) during the same period of maxillary anterior tooth implantation.

抄録

上顎前歯部インプラントの同時期に、ガイド下骨再生（Bio-Gide collagen membrane +Bio-OSS bone powder（牛骨から抽出した炭酸アパタイト結晶）、骨欠損の表面にBio-OSS骨粉を置き、Bio-Gide membraneで覆って傷を塞ぐ）の骨増量に対する切開デザインの違いの影響を探索した。口内炎科の患者99名を小切開（N=30，A群），広切開（N=39，B群），内歯肉溝切開（N=30，C群）の3群に分類し，小切開と広切開を比較検討した．手術直後、6ヶ月後、12ヶ月後、24ヶ月後の各時点で、インプラントマージン（2mm、4mm、6mm）の唇側骨の幅と高さは、3群のいずれにも有意差はなかった（p>0.05）。審美性のスコアはA群がC群に比べ有意に高かった（P<0.05）．PPD，SHの発生率，BOPはいずれもA群がB群より有意に高かった（P＜0.05）．A群のPISm，PISd，PPD，SH，BOPの発生率は，いずれもC群より有意に高かった（P＜0.05）．B群のPISm，PISd，PPD，SHおよびBOPの発生率は，いずれもC群より有意に高かった（P＜0.05）．骨増生の影響については3群間で有意差はなかった．術後のインプラント周囲の軟組織状態は、他の2つの切開法よりも内歯肉溝切開法の方が良好であり、小切開法よりも大切開法の方が良好であった。

Exploring the influence of different incision designs on bone increment of guided bone regeneration [Bio-Gide collagen membrane +Bio-OSS bone powder (carbonate apatite crystal extracted from bovine bones), Bio-OSS bone meal was placed on the surface of the bone defect and then covered with a Bio-Gide membrane to close the wound] during the same period of maxillary anterior tooth implantation. The 99 patients from the stomatology department were divided into 3 groups: small incision (N = 30, group A), wide incision (N = 39, group B), internal gingival sulcus incision (N = 30, group C). At the different time (immediately after surgery, 6 months, 12 months and 24 months), the width and height of labial bone at different implant margin (2 mm, 4 mm, 6 mm) has no significant difference in comparison of any two of the three groups (p > 0.05). The score of esthetic feeling in group A was significant higher than group C (P < 0.05). The PPD, the incidence of SH, BOP in group A were all significant higher than group B (P < 0.05). The PISm, PISd, PPD, the incidence of SH and BOP in group A were all significant higher than group C (P < 0.05). The PISm, PISd, PPD, the incidence of SH and BOP in group B were all significant higher than group C (P < 0.05). The three groups has no significant different on the influence bone increment. The soft tissue condition around the implant after surgery was better in internal gingival crevicular incision than others two incisions, large-scale incision better than small incisions.