口腔疾病防治 ›› 2020, Vol. 28 ›› Issue (6): 404-408.DOI: 10.12016/j.issn.2096-1456.2020.06.012

• 综述 • 上一篇    

引导骨再生屏障膜材料临床应用进展

任立志1,孙睿2()   

  1. 1. 山西医科大学口腔医学院·口腔医院口腔颌面外科,山西 太原(030001)
    2. 山西医科大学附属省人民医院口腔颌面外科,山西 太原(030012)
  • 收稿日期:2019-05-27 修回日期:2019-12-29 出版日期:2020-06-20 发布日期:2020-05-28
  • 通讯作者: 孙睿
  • 作者简介:任立志,医师,硕士,Email: 18435149492@163.com

New progress in the clinical application of GBR membrane materials

REN Lizhi1,SUN Rui2()   

  1. 1. Department of Oral and Maxillofacial Surgery, Shanxi Medical University and Hospital of Stomatology, Taiyuan 030001, China
    2. Department of Oral and Maxillofacial Surgery, Shanxi Provincial People′s Hospital, Taiyuan 030012, China
  • Received:2019-05-27 Revised:2019-12-29 Online:2020-06-20 Published:2020-05-28
  • Contact: Rui SUN

摘要:

引导骨再生(guided bone regeneration,GBR)屏障膜对重建牙周组织的形态和功能具有重要意义。生物相容性、空间保持性、封闭性、可控性和生物活性是屏障膜应满足的主要标准。人工屏障膜生物材料可以分为合成高分子材料类、天然高分子材料类以及金属类,根据其降解特性分为可吸收与不可吸收两大类。用于水平向骨增量的GBR可以治疗多种类型的骨缺损,包括治疗骨开窗、骨开裂,使用不可吸收e-聚四氟乙烯(polytetrafluoroethylene,PTFE)膜或可吸收胶原膜都可以达到很好的预期效果。而对于牙槽嵴顶上增量或垂直向骨增量挑战性大,需要其有良好的强度,维持成骨空间,可以通过使用形态稳定的钛增强e-PTFE或d-PTFE膜,或者也可以使用钛板或钛网覆盖可吸收膜来实现垂直向的骨增量。目前生物活化性膜、数字化3D打印钛网膜、压电活性生物膜为研究热点,在未来的研究中会进一步提高膜的生物活化性,会推进人工膜研发进入下一个阶段。

关键词: 引导性骨再生, 屏障膜, 生物活化性膜, 数字化3D打印钛网膜, 压电活性生物膜, 水平向骨增量, 垂直向骨增量

Abstract:

Guided bone regeneration (GBR) barrier membranes are of great significance for the reconstruction of the health and function of different periodontal tissues. Biocompatibility, spatial maintenance, closure, controllability and biological activation are the main criteria that should be met by these membranes. Artificial barrier membrane biomaterials can be divided into synthetic polymer materials, natural polymer materials and metals. According to their degradation characteristics, these membranes can be divided into two categories, absorbable and nonabsorbable membranes. GBR used for horizontal bone increments can be used to treat various types of bone defects, including the treatment of bone fenestration and bone cracking. The use of a non-absorbable e-PTFE membrane or absorbable collagen membrane can achieve the expected effect. However, for incremental or vertical bone growth at the alveolar crest, the use of this membrane is very challenging and requires good strength to maintain the osteogenic space. This space can be enhanced with e-PTFE or d-PTFE membranes with stable morphology, or absorbable membranes can be covered with titanium plates or meshes to achieve vertical bone increments. Currently, bioactive membranes, digital 3D-printed titanium membranes and piezoelectric active biological membranes are research hotspots. In future research, the biological activation of these membranes will be further improved, which will promote the development of artificial membranes in the next stage.

Key words: guided bone regeneration, barrier membrane, biological activated membrane, digital 3D printing of titanium membrane, piezoelectric biofilm, horizontal bone regeneration, vertical bone regeneration

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