探讨正畸治疗前骨增量手术中使用可吸收膜和不可吸收膜在牙槽骨再生方面的区别。

在佛山市口腔医院正畸科2018年8月至2019年8月就诊的成人患者中通过锥形束CT（CBCT）检查选取下前牙区骨开窗骨开裂的错畸形患者40例作为研究对象，使用随机数字表方法将患者随机分为两组，每组20例，其中一组在治疗过程中覆盖的生物膜材料选择可吸收膜（可吸收膜组），另外一组治疗过程中覆盖的生物膜材料选择不可吸收膜（不可吸收膜组），在充分告知知情同意下进行手术。通过CBCT测量术前及术后半年每颗下前牙唇舌侧牙槽嵴顶距釉牙骨质界的距离及唇舌侧根尖区牙槽骨厚度，并由此计算术前及术后半年唇舌侧牙槽骨高度及厚度增量变化的情况，使用t检验对比可吸收膜组与不可吸收膜组唇舌侧牙槽骨高度及厚度增量。

可吸收膜组接受牙周辅助加速成骨正畸治疗后，唇侧牙槽骨高度增量平均为（1.8 ± 0.5）mm，舌侧牙槽骨高度增量平均为（0.6 ± 0.5）mm，唇侧牙槽骨厚度增量平均为（2.3 ± 0.5）mm，舌侧牙槽骨厚度增量平均为（0.5 ± 0.6）mm；不可吸收膜组接受牙周辅助加速成骨正畸治疗后，唇侧牙槽骨高度增量平均为（2.1 ± 0.5）mm，舌侧牙槽骨高度增量平均为（0.7 ± 0.6）mm，唇侧牙槽骨厚度增量平均为（2.4 ± 0.6）mm，舌侧牙槽骨厚度增量平均为（0.4 ± 0.5）mm。可吸收膜组唇侧牙槽骨高度增量与不可吸收膜组唇侧牙槽骨高度增量差异有统计学意义（t=-2.250，P=0.03），舌侧牙槽骨高度增量差异无统计学意义（t=-0.547，P=0.587），唇侧牙槽骨厚度增量差异无统计学意义（t=-0.534，P=0.596），舌侧牙槽骨厚度增量差异无统计学意义（t=-0.826，P=0.414）。

术中使用不可吸收膜可以显著增加唇侧牙槽骨高度，但二次手术对患者接受度的影响仍有待研究。

To investigate the difference between resorbable membrane and non-resorbable membrane in alveolar bone augmentation before orthodontic treatment.

Forty adult malocclusion patients with bone dehiscence in the lower anterior teeth area through cone-beam CT (CBCT) examination were selected in the orthodontics department of Foshan stomatological hospital from August 2018 to August 2019. They were randomly divided into two groups by random number table. In one group, the absorbable membrane was used during the treatment, which was classified as absorbable membrane group. In the other group, the non-absorbable membrane was used during the treatment, which was classified as non-absorbable membrane group. Patients were Informed consent of using absorbable membrane or non-absorbable membrane before surgery. CBCT was used to measure the distance between the labial/lingual alveolar crest and enamel cementum boundary and the thickness of labial/lingual alveolar bone in apical area of each lower anterior tooth before and half a year after operation. The height and thickness increment of labial/lingual alveolar bone were calculated. T-test was used to compare the difference of labial/lingual alveolar bone height and thickness increment between absorbable membrane group and non-absorbable membrane group.

The average height increment of labial alveolar bone was (1.8 ± 0.5) mm, lingual alveolar bone was (0.6 ± 0.5) mm, labial alveolar bone thickness increment was (2.3 ± 0.5) mm and lingual alveolar bone thickness increment was (0.5 ± 0.6) mm in the absorbable membrane group. The average height increment of labial alveolar bone was (2.1 ± 0.5) mm, lingual alveolar bone was (0.7 ± 0.6) mm, labial alveolar bone thickness increment was (2.4 ± 0.6) mm and lingual alveolar bone thickness increment was (0.4 ± 0.5) mm in the non-absorbable membrane group. The results showed that there was significant difference in the height increment of labial alveolar bone between absorbable membrane group and non-absorbable membrane group (t=-2.250, P = 0.03) . There was no significant difference in the height increment of lingual alveolar bone between absorbable membrane group and non-absorbable membrane group (t=-0.547, P = 0.05) as well as in the thickness increment of labial alveolar bone (t=-0.534, P = 0.596) and lingual alveolar bone (t=-0.826, P = 0.587) .

The application of non-resorbable membrane can significantly increase the height of labial alveolar bone, but the acceptability of patients remains for reoperation still need to be studied.