牙周再生性手术双语-同济口腔医学课件.ppt

* 24 牙周再生性手术 Regenerative Periodontal Surgery 手术的目的在于获得牙周组织再生的手术，叫做再生性手术 the use of regenerative procedures aimed at restoring the lost periodontal support 牙周组织再生 牙槽骨 ＰＤＬ 牙骨质 Periodontal Regeneration? 牙周膜血管通道 　　　　　牙周前体细胞 牙周膜 牙周组织再生的细胞生物学基础 24-1 引导组织再生术 Guided Tissue Regeneration Following flap surgery, the curetted root surface may be repopulated by (1) epithelial cells, (2) Gingival connective tissue cells, (3) bone cells, or (4) periodontal ligament cells. The exclusion of epithelial and gingival connective tissue cells from the healing area by the use of a physical barrier may allow (guide) periodontal ligament cells to repopulate the detached root surface. This observation provided the basis for the clinical application of the treatment principle termed guided tissue regeneration (GTR). 原理 Drawing illustrating the placement of the physical barrier which prevents the epithelium and gingival connective tissue from contacting the root surface during healing. At the same time the membrane allows cells from the periodontal ligament (arrow) to repopulate the previously periodontitis-involved root surface. Microphotograph of membrane (M) covered root. 用于再生性手术的屏障膜材料 Barrier Materials for Regenerative Surgery Essential design criteria: Biocompatibility: good tissue acceptance Barrier: exclude undesirable cell types from entering the secluded space adjacent to the root surface. Tissue integration : tissue may grow into the material without penetrating all the way through. Maintaining a space maintaining a space adjacent to the root surface. Easy to trim and to place. Maintaining a space Barrier materials for regenerative surgery Non-Bioabsorbable materials PTFE Bioabsorbable materials 手术要点： 1，膜的放置位置 2，瓣缝合 3，术后护理 4，膜的放置时间 Cases 24-2 植骨术　Bone Graft Procedures The grafting materials in pe