国际口腔医学杂志

国际口腔医学杂志 ›› 2026, Vol. 53 ›› Issue (1): 84-90.doi: 10.7518/gjkq.2026005

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颊壁形态影响牙周炎位点牙槽嵴保存的应用进展

陈可儿(),包佳琦,孙伟莲()   

  1. 浙江大学医学院附属第二医院牙周病专科 杭州 310009
  • 收稿日期:2024-12-11 修回日期:2025-04-02 出版日期:2026-01-01 发布日期:2025-12-31
  • 通讯作者: 孙伟莲
  • 作者简介:陈可儿，硕士，Email：keerchenlily@163.com
  • 基金资助:
    浙江省基础公益研究计划(LTGY23H140005)

Application progress of buccal wall morphology affecting alveolar ridge preservation at periodontitis sites

Keer Chen(),Jiaqi Bao,Weilian Sun()   

  1. Dept. of Periodontology, the Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, China
  • Received:2024-12-11 Revised:2025-04-02 Online:2026-01-01 Published:2025-12-31
  • Contact: Weilian Sun
  • Supported by:
    Basic Public Welfare Research Project of Zhejiang Province(LTGY23H140005)

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摘要：

牙周炎是成年患者拔牙的常见原因之一。拔牙后牙槽窝常伴骨吸收，进而影响后续的种植修复效果。牙槽嵴保存术是在拔牙同期将生物材料植入拔牙窝内的骨增量手术，有助于延缓牙槽骨吸收、恢复牙槽嵴的美观与功能。与非牙周炎拔牙窝相比，牙周炎拔牙窝的愈合过程更复杂多变，其中颊侧骨壁形态对拔牙窝愈合后的骨组织线性和体积变化、软组织量改变及组织学特征具有重要影响。本文针对不同颊侧骨壁形态影响牙周炎拔牙位点牙槽嵴保存术的应用进行总结与分析，发现颊壁厚者较薄者减缓牙槽骨吸收效果更为明显，颊壁缺损位点较完整位点需要额外的软硬组织增量手术，为不同适应证下的牙槽嵴保存术式选择提供了诊疗思路。

关键词: 牙周炎, 拔牙, 牙槽嵴保存术, 颊侧骨壁形态

Abstract:

Periodontitis is one of the common causes of tooth extraction in adult patients. After tooth extraction, the alveolar cavity frequently undergoes bone resorption, which in turn affects the efficacy of implant restoration. Alveolar ridge preservation (ARP) is a bone augmentation procedure involving the implantation of biological materials into the extraction socket during tooth extraction. It delays alveolar bone resorption and restores the aesthetic and functional integrity of the alveolar ridge. In contrast to non-periodontitis tooth extraction pits, periodontitis tooth extraction pits features a more intricate and diverse healing process. The morphology of the buccal bone wall considerably influences linear and volumetric changes in bone tissue, changes in soft tissue volume and histological features after the healing of tooth extraction pits. This article summarizes and analyzes the influence of various buccal bone wall configurations on the efficacy of ARP in periodontitis tooth extraction sites. Thick buccal walls influenced the deceleration of alveolar bone resorption more markedly than thin buccal walls, whereas extensive buccal wall defect sites necessitated supplementary soft and hard tissue augmentation surgery. This study offers initial diagnostic and therapeutic concepts for the selection of surgical interventions for ARP on the basis of various indications.

Key words: periodontitis, tooth extraction, alveolar ridge preservation, buccal bone wall morphology

中图分类号: 

  • R781.4

表 1

ST分类法"

拔牙窝类型ST1ST2ST3
ST1AST1BST3AST3BST3C
形态颊壁完整，厚度≥1 mm颊壁完整，厚度<1 mm颊壁骨开窗颊壁骨开裂，≤1/3颊壁高度颊壁骨开裂，1/3~2/3颊壁高度颊壁骨开裂，≥2/3颊壁高度
再生潜能高较高中较低低极低
是否行ARP否是是是是是
生物材料无胶原蛋白交联可吸收膜交联可吸收膜d-PTFE膜d-PTFE膜
创口愈合一期一期一期一期二期二期
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