以含骨移植體之膠原蛋白栓同時進行口鼻竇腔相通關閉與齒槽塉保留－病例報告

Simultaneous Oroantral Communication Closure and Socket Preservation with Graded Collagen Plug-A Case Report

黃薇蓁(Wei-Chen Huang)；鄭人瑋(Jen-Wei Cheng)；陳畊仲(Ken-Chang Chen)

口鼻相通 ； 膠原蛋白栓 ； 骨代用品 ； 骨移植體 ； 齒槽保存 ； Oroantral communication ； Collagen tag ； Bone substitute ； Bone graft ； Socket preservation

臺灣口腔顎面外科學會雜誌

35卷3期（2024 / 09 / 01）

219 - 229

繁體中文;英文

口鼻竇相通定義為在口腔與鼻竇之間，產生原本不存在的開口通道，常見於上顎後牙拔牙併發症。傳統處理方法從單純軟組織修補到骨組織重建，或生醫材料放置。軟組織修補雖然較為簡單，但無法同時填補骨缺損。同時進行骨豐隆手術，手術較複雜，時間較長，可能需要同時進行鼻竇增高術以及額外費用。近年來有不少新方法及生醫材料可不需完全縫合傷口，即達成修補口鼻相通，但仍無法同時引導骨再生，填補骨缺損。本病例報告一口鼻竇相通病患，置入含骨代用品之膠原蛋白栓。僅使用傳統頰前移皮瓣，無另外進行鼻竇增高術。術後口鼻竇相通癒合良好，放射線學檢查也可發現拔牙骨缺損處有良好骨再生。文獻回顧類似材料已成功使用於齒槽保存術等骨豐隆手術，本病例首次使用於口鼻竇相通修補，並同時保存齒槽骨，有良好效果。

Oroantral communication is defined as the creation of a non-existent open passage between the oral cavity and the sinuses. It is often taken as a complication of maxillary posterior tooth extraction. Traditional treatments range from soft tissue repair to bone tissue reconstruction or placement of biomedical materials. Although soft tissue repair is relatively simple, it cannot simultaneously fill bone defects. Bone augmentation simultaneously is more complicated, time-consuming, and may require sinus elevation surgery and additional costs. In recent years, many new methods and biomedical materials are used to repair oroantral communication without complete wound closure. However, they cannot simultaneously guide bone regeneration and fill the bone defect. We reported a case of oroantral communication, with applying a collagen plug containing a bone substitute in the extraction socket. Only conventional buccal advancement flaps were used to priminly close the wound. The oroantral communication healed well after the operation, and radiological examination also showed good bone regeneration in the alveolar bone defect. The literature review reveals that similar materials have been successfully used in bone augmentation surgery, such as socket preservation. This was the first case of using collagen plug to repair oroantral communication and simultaneously presere socket.