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補骨粉是什麼？費用多少、會痛嗎？｜證據鏈

km 編輯部2026-08-13閱讀約 50 分鐘
#證據鏈#牙醫KM#台灣#補骨

本頁是〈補骨粉是什麼？費用多少、會痛嗎？〉的事實單元帳：每一條主張對應的來源、證據等級、地域與期間、原文引句與限制，逐條攤開。

補骨粉是什麼？費用多少、會痛嗎？｜證據鏈

F-Units（事實單元帳）

每條標明 confidence／basis／period／geo／逐字 span／caveat。basis 階梯：law ＞ official_statement ＞ clinical_guideline ＞ peer_reviewed ＞ textbook。

  • F1｜confidence: verified｜basis: law（醫療法第 21 條，全國法規資料庫 2026-08-06 實測 HTTP 200）｜period: 現行條文｜geo: TW｜span:「醫療機構收取醫療費用之標準，由直轄市、縣（市）主管機關核定之。」｜caveat: 條文本身不含任何金額，本卡不引用任何核定金額。
  • F2｜confidence: verified｜basis: law（醫療法第 22 條，2026-08-06 實測 HTTP 200）｜period: 現行條文｜geo: TW｜span:「醫療機構收取醫療費用，應開給載明收費項目及金額之收據。」「醫療機構不得違反收費標準，超額或擅立收費項目收費。」｜caveat: 屬收費行政規範，非個案法律意見。
  • F3｜confidence: verified｜basis: law（醫療法第 63 條，2026-08-06 實測 HTTP 200）｜period: 現行條文｜geo: TW｜span:「醫療機構實施手術，應向病人或其法定代理人、配偶、親屬或關係人說明手術原因、手術成功率或可能發生之併發症及危險，並經其同意，簽具手術同意書及麻醉同意書，始得為之。但情況緊急者，不在此限。」｜caveat: 引用其告知與同意規範，未就個案效力作法律判斷。
  • F4｜confidence: verified｜basis: law（醫療法第 81 條，2026-08-06 實測 HTTP 200）｜period: 現行條文｜geo: TW｜span:「醫療機構診治病人時，應向病人或其法定代理人、配偶、親屬或關係人告知其病情、治療方針、處置、用藥、預後情形及可能之不良反應。」｜caveat: 條文引述，非法律意見。
  • F5｜confidence: verified｜basis: law（醫療法第 87 條第 2 項，2026-08-06 實測 HTTP 200）｜period: 現行條文｜geo: TW｜span:「醫學新知或研究報告之發表、病人衛生教育、學術性刊物，未涉及招徠醫療業務者，不視為醫療廣告。」｜caveat: 本條為本卡合規註記之定位依據。
  • F6｜confidence: verified｜basis: law（全民健康保險法第 51 條第 11 款，2026-08-06 實測 HTTP 200）｜period: 現行條文｜geo: TW｜span:「義齒、義眼、眼鏡、助聽器、輪椅、拐杖及其他非具積極治療性之裝具。」｜caveat: 條文列舉的是不給付項目；補骨相關處置之給付與否以健保署現行公告為準，本卡不作給付判定。同錨亦用於 KM-DENTAL-09 與 KM-DENTAL-28。
  • F7｜confidence: verified｜basis: law（醫療器材管理法第 25 條第 1 項，2026-08-06 實測 HTTP 200）｜period: 現行條文｜geo: TW｜span:「製造、輸入醫療器材，應向中央主管機關申請查驗登記，經核准發給醫療器材許可證後，始得為之。但經中央主管機關公告之品項，其製造、輸入應以登錄方式為之。」｜caveat: 本卡僅引用查驗登記與許可證制度的存在，未對任何特定產品作核准狀態之認定；本次檢索未能取得可實測的官方許可證查詢介面（info.fda.gov.tw 於 2026-08-06 本機 DNS 無法解析），故本卡不提供線上查證連結，只建議向院所索取書面產品品名。
  • F8｜confidence: verified｜basis: peer_reviewed（Cochrane systematic review，PMID 33899930，CD010176.pub3）｜period: 檢索至 2021-03-19，2021 刊出；為 2015 年初版之更新版，2026-08-06 以 PubMed 依刊出日排序檢索同題 Cochrane 條目，未見更新的 pub4｜geo: universal｜span:「Alveolar bone changes following tooth extraction can compromise prosthodontic rehabilitation. Alveolar ridge preservation (ARP) has been proposed to limit these changes and improve prosthodontic and aesthetic outcomes when implants are used.」「We included all randomised controlled trials (RCTs) on the use of ARP techniques with at least six months of follow-up.」「We included 16 RCTs conducted worldwide involving a total of 524 extraction sites in 426 adult participants.」「from the seven trials comparing xenografts with extraction alone, there is very low-certainty evidence of a reduction in loss of alveolar ridge width」「ARP techniques may minimise the overall changes in residual ridge height and width six months after extraction but the evidence is very uncertain.」「There is lack of evidence of any differences in the need for additional augmentation at the time of implant placement, implant failure, aesthetic outcomes, or any other clinical parameters due to lack of information or long-term data.」「There is no evidence of any clinically significant difference between different grafting materials and barriers used for ARP.」「No serious adverse events were reported with most trials indicating that the procedure was uneventful.」「Among the complications reported were delayed healing with partial exposure of the buccal plate at suture removal, postoperative pain and swelling, moderate glazing, redness and oedema, membrane exposure and partial loss of grafting material」「This is an update of the Cochrane Review first published in 2015.」｜caveat: 證據確定性很低；不得改寫為「補骨可以避免日後再補骨」。併發症樣態僅作一句摘述，分級與紅旗判準見 KM-DENTAL-28。同錨亦用於 KM-DENTAL-09。
  • F9｜confidence: verified｜basis: peer_reviewed（systematic review・meta-analysis，PMID 30623987）｜period: 2019 刊出（J Clin Periodontol 46 Suppl 21）；2026-08-06 檢索，同主題較新者為 2022 年網絡統合分析（見 F10），本條數值為對照「單純拔牙」的合併效果來源｜geo: universal｜span:「All these different ARP modalities were compared to the control therapy (i.e. spontaneous socket healing) in each individual study after a 3- to 6-month healing period.」「The results of a pooled quantitative analysis revealed that ARP via socket grafting (ARP-SG), as compared to tooth extraction alone, prevents horizontal (M = 1.99 mm; 95% CI 1.54-2.44; p < 0.00001), vertical mid-buccal (M = 1.72 mm; 95% CI 0.96-2.48; p < 0.00001) and vertical mid-lingual (M = 1.16 mm; 95% CI 0.81-1.52; p < 0.00001) bone resorption.」「A specific quantitative analysis showed that sites presenting a buccal bone thickness >1.0 mm exhibited more favourable ridge preservation outcomes (difference between ARP [AG + SS] and control = 3.2 mm), as compared to sites with a thinner buccal wall (difference between ARP [AG + SS] and control = 1.29 mm).」「Whether there is a superior ARP or SS approach could not be determined on the basis of the selected evidence.」｜caveat: 合併值為組間差異的群體估計，非個人可預期的毫米數；該文於 2020 年有勘誤（J Clin Periodontol 47(1):129），本卡引用之數值段落未見更動。
  • F10｜confidence: verified｜basis: peer_reviewed（systematic review・network meta-analysis，PMID 34826029）｜period: 檢索至 2021-03，2022 刊出；2026-08-06 檢索，之後同題網絡統合分析多為單一材料主題（如 2025 年自體牙本質顆粒），未見取代此篇的廣譜更新版｜geo: universal｜span:「Eighty-eight RCTs were included, with a total of 2805 patients and 3073 sockets.」「Overall, a total of 1740 sockets underwent alveolar ridge preservation with different materials (1432 were covered by a membrane).」「Pairwise meta-analysis showed that, as compared to spontaneous healing, all materials statistically significantly reduced horizontal and vertical shrinkage.」「According to the multidimensional scale ranking of the NMA, xenografts (XG) and allografts (AG), alone or combined with bioactive agents (Bio + AG), were the most predictable materials for horizontal and vertical ridge dimension preservation, while platelet concentrates performed best in the percentage of new bone formation.」「even if they presented the worst histological outcomes」｜caveat: 網絡統合分析的排序是研究層級的相對比較，不能外推為個人療效；本卡不引用任何產品名稱。
  • F11｜confidence: verified｜basis: peer_reviewed（systematic review・meta-analysis，PMID 30624791）｜period: 檢索至 2018-05，2019 刊出；2026-08-06 檢索，同臨床問題另有 2023 年網絡統合分析（PMID 37752820，已用於 KM-DENTAL-28），本條保留於材料與屏障膜的效果面｜geo: universal｜span:「In these included studies and populations, various modalities for primary lateral bone augmentation rendered implant placement feasible.」「Bone width gain was significantly inversely associated with baseline bone width (pooled effect: -0.35 mm/mm; 95% CI: -0.63 to -0.07 mm; p = 0.01).」「The presence of xenograft added to autologous graft led to less resorption compared to autologous graft alone (MD: 1.06 mm; 95% CI: 0.21 to 1.92 mm; p = 0.01).」「Barrier membrane did not yield significant difference in terms of bone width gain (MD: -0.33 mm; 95% CI: -2.24 to 1.58 mm; p > 0.05)」「However, the quality of evidence ranged from very low to moderate due to bias and imprecision.」｜caveat: 作者自陳證據品質很低至中等；「加膜沒有顯著差異」是該回顧在骨寬度增加量此一指標上的結果，不等於臨床上不需要屏障膜。同錨亦用於 KM-DENTAL-09。
  • F12｜confidence: verified｜basis: clinical_guideline（共識報告與臨床建議，PMID 31215112，XV European Workshop in Periodontology 第 3 組）｜period: 2019 刊出｜geo: universal｜span:「The group identified six considerations that should assist clinicians in clinical decision-making: presence of infection, inability to achieve primary stability in the restoratively driven position, presence of a damaged alveolus, periodontal phenotype, aesthetic demands and systemic conditions.」「The group emphasized that the evidence base mostly relates to single tooth extraction/replacement; hence, external validity/applicability to multiple extractions requires careful consideration.」｜caveat: 為共識層級文件，本卡僅引用其決策考量清單，未引用個別術式建議。
  • F13｜confidence: verified｜basis: peer_reviewed（systematic review・meta-analysis，PMID 30624789）｜period: 檢索至 2018-05，2019 刊出；2026-08-06 檢索，之後同題系統性回顧多聚焦特定材料或細胞治療，未見取代此篇的長期效果更新版｜geo: universal｜span:「Inclusion criteria were prospective studies with follow-up ≥5 years and a residual bone height ≤6 mm.」「Meta-analysis revealed a weighted annual implant loss of 0.43% (95% CI: 0.37%-0.49%).」「Meta-regression analysis did not reveal significant differences in implant loss neither between edentulous and dentate patients nor implants placed simultaneously with or delayed after MSFA, nor implants placed in MSFA using solely autologous bone or bone substitutes.」｜caveat: 限側窗技術、殘存骨高度 ≤6 毫米之族群；年失敗率為群體估計，非個人風險。
  • F14｜confidence: verified｜basis: peer_reviewed（systematic review・meta-analysis with trial sequential analysis，PMID 38757030）｜period: 檢索 1980-01 至 2023-05，2024 刊出｜geo: universal｜span:「Seventeen studies, including 547 sinuses and 696 implants, were pooled for the meta-analysis.」「The meta-analysis showed no statistically significant difference between MSFE without bone grafts and conventional MSFE in terms of the implant survival rate in the short term」「Although conventional MSFE had a higher endo-sinus bone gain (n = 13, I2 = 89%, weighted mean difference (WMD): -1.24, 95% CI: -1.91- -0.57, p = 0.0003, RIS = 461), this was not a determining factor in implant survival.」「This systematic review revealed that both non-graft and grafted MSFE had high implant survival rates. Owing to the moderate strength of the evidence and short-term follow-up, the results should be interpreted with caution.」｜caveat: 屬臨床決策層面的比較，非「病人可自行選擇不填」的依據；追蹤期短、證據強度中等。
  • F15｜confidence: verified｜basis: peer_reviewed（systematic review，PMID 40806953）｜period: 檢索至 2025-06，2025 刊出｜geo: universal｜span:「Six articles were finally included based on the exclusion and inclusion criteria with a total of 295 patients.」「The overall study quality was low, since only two RCTs could be included.」「Meta-analysis was not achievable due to a lack of direct comparisons and heterogeneity in terms of PROMs.」「this systematic review concluded that ABB and GBR are well-tolerated procedures. Trends such as transient postoperative pain and swelling with a minor occurring of neurosensory disturbances were reported in a few studies.」「Patient-reported outcomes were only analyzed for patients who completed the entire follow-up period. This may introduce bias, as patients who dropped out and were more likely to experience complications were not represented, potentially resulting in a more favorable portrayal of the outcomes.」｜caveat: 僅 6 篇納入、2 篇為隨機對照試驗，作者自陳品質偏低且有存活者偏誤；不得改寫為疼痛程度的承諾或比較。術後不適時程與併發症分級見 KM-DENTAL-28。
  • F16｜confidence: verified｜basis: peer_reviewed（technical note・case series，PMID 38398468）｜period: 2024 刊出｜geo: universal｜span:「All cases were performed under local anesthesia.」｜caveat: 為病例系列的術式描述，證據等級低，僅用於「文獻中的骨增生手術在局部麻醉下進行」此一程序事實，不作療效或疼痛程度推論；個別麻醉方式由醫師依病人狀況決定。
  • F17｜confidence: verified｜basis: peer_reviewed（systematic review・meta-analysis，PMID 31860134）｜period: 納入 1990 至 2019 之隨機對照試驗，2020 刊出；為歐洲牙周病聯盟 S3 指引之委託回顧之一，2026-08-06 檢索，較新的同題證據見 F18、F19｜geo: universal｜span:「Electronic and hand searches were performed to identify randomized clinical trials (RCTs) on regenerative treatment of deep intra-bony defects (≥3 mm) with a follow-up of at least 12 months.」「A total of 79 RCTs (88 articles) published from 1990 to 2019 and accounting for 3,042 patients and 3,612 intra-bony defects were included in this systematic review.」「All regenerative procedures provided adjunctive benefit in terms of CAL gain (1.34 mm; 0.95-1.73) compared with open flap debridement alone.」「Among biomaterials, the addition of deproteinized bovine bone mineral (DBBM) improved the clinical outcomes of both GTR with resorbable barriers and EMD.」「The strength of evidence was low to moderate.」｜caveat: 限深度 ≥3 毫米之骨內缺損，且僅 10 篇納入研究被評為低偏誤風險；不可外推為「所有搖動的牙齒補骨都有效」。
  • F18｜confidence: verified｜basis: peer_reviewed（systematic review・network meta-analysis，PMID 33289191）｜period: 納入追蹤 ≥3 年之隨機對照試驗，2021 刊出｜geo: universal｜span:「Thirty RCTs, presenting data 3 to 20 years after treatment with grafting, GTR, EMD, as monotherapies, combinations thereof, and/or adjunctive use of blood-derived growth factor constructs or with OFD only, were included.」「Tooth loss after regenerative/reconstructive treatment was less frequent (0.4%) compared to OFD (2.8%), but the evidence was sparse.」「A clear hierarchy could, however, not be established due to limited evidence.」｜caveat: 作者明言牙齒喪失部分證據稀少且無法建立療法優劣階層，不得改寫為療效承諾。
  • F19｜confidence: verified｜basis: peer_reviewed（systematic review・meta-analysis，PMID 40897233）｜period: 檢索至 2024-12-18，2025 刊出；為本卡牙周段中刊出年份較近的同題證據（檢索日 2026-08-06）｜geo: universal｜span:「Twenty-one RCTs (739 patients, 828 defects) met inclusion criteria.」「Combination therapy resulted in significantly greater PPD reduction (mean difference: 0.38 mm; p = 0.02) and RBL gain (0.81 mm; p = 0.003). CAL gain showed a favorable but non-significant trend (0.30 mm; p = 0.22).」「supporting a selective rather than systematic use in periodontal regenerative procedures」｜caveat: 比較的是「生物製劑單用」與「生物製劑加骨移植材料」，不是「補骨對照不補骨」；差異幅度有限，且作者主張選擇性使用。
  • F20｜confidence: verified｜basis: clinical_guideline（S3 等級臨床實務指引，PMID 32383274，歐洲牙周病聯盟）｜period: 2020 刊出（2021 年有勘誤）｜geo: universal｜span:「The S3 CPG approaches the treatment of periodontitis (stages I, II and III) using a pre-established stepwise approach to therapy that, depending on the disease stage, should be incremental, each including different interventions.」「Consensus was achieved on recommendations covering different interventions, aimed at (a) behavioural changes, supragingival biofilm, gingival inflammation and risk factor control; (b) supra- and sub-gingival instrumentation, with and without adjunctive therapies; (c) different types of periodontal surgical interventions; and (d) the necessary supportive periodontal care to extend benefits over time.」｜caveat: 本卡僅引用其階梯式治療架構，未引用個別介入措施之推薦強度；台灣臨床實務仍依主治醫師判斷與健保署規定。
  • F21｜confidence: verified｜basis: official_statement（臺北市政府衛生局公告＋政府資料開放平臺資料集）｜period: 1090117 核定；兩頁 2026-08-06 以 ego-browser 實測可達，頁面標題逐字相符｜geo: TW｜span（頁面標題）:「臺北市政府衛生局-收費標準-「臺北市醫療機構牙科收費標準表」(1090117核定)」；資料集標題「臺北市醫療收費標準 ｜ 政府資料開放平臺」（資料集編號 121913）｜caveat: 僅為一個縣市的已驗例證，其他縣市各自公告；本卡不引用其中任何金額，亦未逐項確認該表是否列有骨移植相關處置。
  • F22｜confidence: verified｜basis: official_statement（本站瀏覽器實測，2026-08-05 首驗、2026-08-06 於 KM-DENTAL-09 複驗，同錨）｜period: 實測當日狀態｜geo: TW｜實測紀錄: 健保署醫材比價網自付差額醫材比價查詢頁（INAE2011S01）之醫材類別 12 項、醫材收費比價查詢頁（INAE2012S01）之手術及處置類別 8 項，兩頁 document.body.innerText 皆不含「牙」字，故牙科自費品項（含骨移植材料）無法由該網查證｜caveat: 為實測當日之資料狀態，官方資料庫可能更新，引用時請註明查證日期。本條為「不可用作查證管道」之否定性結論，不是價格資訊。
  • F23｜confidence: verified｜basis: internal_dataset（內部資料 GSC，非醫學 basis；發布轉檔時整條不輸出）｜period: 資料窗 2025-03～2026-08｜geo: TW｜本題查詢族共 14 個詞項、跨 6 個站，逐筆可對帳；選題證據數值保留於草稿 frontmatter 與內部檔案，發布轉檔時不進可見層（2026-08-05 裁定）。
  • F24｜無外部來源｜結構性整理（編輯框架，非事實宣稱）｜「三種情況」的分流、材料四類的排列、費用六塊拆項、checklist 七題與本卡與 KM-DENTAL-28 的分工聲明，均為本站為了讓病人問對問題而定義的說明結構，不是官方分類，也不是臨床指引。
  • F25｜無外部來源｜證據缺口聲明（editorial，非待驗）｜本卡不提供以下內容：①任何金額或價格區間（收費依各縣市核定標準與院所報價而定） ②個人化的療程天數或癒合月數（取決於缺損型態與治療計畫） ③術後併發症的分級與紅旗判準（屬 KM-DENTAL-28） ④任何骨移植材料或屏障膜的品牌比較（本次檢索未取得可支持品牌層級結論的證據，且品牌比較不屬衛教範圍） ⑤保險理賠與契約條款之法律見解。

來源清單

PubMed 條目均於 2026-08-06 以 E-utilities efetch 取回摘要原文並逐字比對，條目頁另以 HTTP 實測回應 200。

  • S1 Atieh MA, Alsabeeha NH, Payne AG, Ali S, Faggion CM Jr, Esposito M. Interventions for replacing missing teeth: alveolar ridge preservation techniques for dental implant site development. Cochrane Database Syst Rev. 2021;4(4):CD010176. PMID 33899930. pubmed.ncbi.nlm.nih.gov/33899930（取用 2026-08-06，HTTP 200，efetch 摘要逐字對得上；pub3＝2015 年初版之更新版，未見更新的 pub4）
  • S2 Avila-Ortiz G, Chambrone L, Vignoletti F. Effect of alveolar ridge preservation interventions following tooth extraction: A systematic review and meta-analysis. J Clin Periodontol. 2019;46 Suppl 21:195-223. PMID 30623987. pubmed.ncbi.nlm.nih.gov/30623987（取用 2026-08-06，HTTP 200，efetch 摘要逐字對得上）
  • S3 Canullo L, Del Fabbro M, Khijmatgar S, et al. Dimensional and histomorphometric evaluation of biomaterials used for alveolar ridge preservation: a systematic review and network meta-analysis. Clin Oral Investig. 2022;26(1):141-158. PMID 34826029. pubmed.ncbi.nlm.nih.gov/34826029（取用 2026-08-06，HTTP 200，efetch 摘要逐字對得上）
  • S4 Naenni N, Lim HC, Papageorgiou SN, Hämmerle CHF. Efficacy of lateral bone augmentation prior to implant placement: A systematic review and meta-analysis. J Clin Periodontol. 2019;46 Suppl 21:287-306. PMID 30624791. pubmed.ncbi.nlm.nih.gov/30624791（取用 2026-08-06，HTTP 200，efetch 摘要逐字對得上）
  • S5 Tonetti MS, Jung RE, Avila-Ortiz G, et al. Management of the extraction socket and timing of implant placement: Consensus report and clinical recommendations of group 3 of the XV European Workshop in Periodontology. J Clin Periodontol. 2019;46 Suppl 21:183-194. PMID 31215112. pubmed.ncbi.nlm.nih.gov/31215112（取用 2026-08-06，HTTP 200，efetch 摘要逐字對得上）
  • S6 Raghoebar GM, Onclin P, Boven GC, Vissink A, Meijer HJA. Long-term effectiveness of maxillary sinus floor augmentation: A systematic review and meta-analysis. J Clin Periodontol. 2019;46 Suppl 21:307-318. PMID 30624789. pubmed.ncbi.nlm.nih.gov/30624789（取用 2026-08-06，HTTP 200，efetch 摘要逐字對得上）
  • S7 Chen J, Lu Y, Xu J, Hua Z. Clinical evaluation of maxillary sinus floor elevation with or without bone grafts: a systematic review and meta-analysis of randomised controlled trials with trial sequential analysis. Arch Med Sci. 2024;20(2):384-401. PMID 38757030. pubmed.ncbi.nlm.nih.gov/38757030（取用 2026-08-06，HTTP 200，efetch 摘要逐字對得上）
  • S8 Salahi S, Shaar MK, Pitman J, et al. Patient-Reported Outcomes in Intraoral Bone Block Augmentation Compared to GBR Procedures Prior to Implant Placement: A Systematic Review. J Clin Med. 2025;14(15):5331. PMID 40806953. pubmed.ncbi.nlm.nih.gov/40806953（取用 2026-08-06，HTTP 200，efetch 摘要逐字對得上）
  • S9 Sohn DS, Lui A, Choi H. Utilization of Tenting Pole Abutments for the Reconstruction of Severely Resorbed Alveolar Bone: Technical Considerations and Case Series Reports. J Clin Med. 2024;13(4):1156. PMID 38398468. pubmed.ncbi.nlm.nih.gov/38398468（取用 2026-08-06，HTTP 200，efetch 摘要逐字對得上；病例系列，僅用於程序描述）
  • S10 Nibali L, Koidou VP, Nieri M, Barbato L, Pagliaro U, Cairo F. Regenerative surgery versus access flap for the treatment of intra-bony periodontal defects: A systematic review and meta-analysis. J Clin Periodontol. 2020;47 Suppl 22:320-351. PMID 31860134. pubmed.ncbi.nlm.nih.gov/31860134（取用 2026-08-06，HTTP 200，efetch 摘要逐字對得上）
  • S11 Stavropoulos A, Bertl K, Spineli LM, Sculean A, Cortellini P, Tonetti M. Medium- and long-term clinical benefits of periodontal regenerative/reconstructive procedures in intrabony defects: Systematic review and network meta-analysis of randomized controlled clinical studies. J Clin Periodontol. 2021;48(3):410-430. PMID 33289191. pubmed.ncbi.nlm.nih.gov/33289191（取用 2026-08-06，HTTP 200，efetch 摘要逐字對得上）
  • S12 Valente NA, Pileri C, Floris L, Carrus N, Natto ZS, Clementini M. Clinical outcomes of periodontal regeneration using biologic agents alone or in combination with graft materials for intrabony defects: A systematic review and meta-analysis. J Dent. 2025;162:106080. PMID 40897233. pubmed.ncbi.nlm.nih.gov/40897233（取用 2026-08-06，HTTP 200，efetch 摘要逐字對得上）
  • S13 Sanz M, Herrera D, Kebschull M, et al. Treatment of stage I-III periodontitis-The EFP S3 level clinical practice guideline. J Clin Periodontol. 2020;47 Suppl 22:4-60. PMID 32383274. pubmed.ncbi.nlm.nih.gov/32383274（取用 2026-08-06，HTTP 200，efetch 摘要逐字對得上）
  • S14 醫療法 第 21 條（全國法規資料庫）。law.moj.gov.tw pcode=L0020021 flno=21（取用 2026-08-06，HTTP 200，條文逐字對得上）
  • S15 醫療法 第 22 條（全國法規資料庫）。law.moj.gov.tw pcode=L0020021 flno=22（取用 2026-08-06，HTTP 200，條文逐字對得上）
  • S16 醫療法 第 63 條（全國法規資料庫）。law.moj.gov.tw pcode=L0020021 flno=63（取用 2026-08-06，HTTP 200，條文逐字對得上）
  • S17 醫療法 第 81 條（全國法規資料庫）。law.moj.gov.tw pcode=L0020021 flno=81（取用 2026-08-06，HTTP 200，條文逐字對得上）
  • S18 醫療法 第 87 條（全國法規資料庫）。law.moj.gov.tw pcode=L0020021 flno=87（取用 2026-08-06，HTTP 200，第 2 項逐字對得上）
  • S19 全民健康保險法 第 51 條（全國法規資料庫）。law.moj.gov.tw pcode=L0060001 flno=51（取用 2026-08-06，HTTP 200，第 11 款逐字對得上）
  • S20 醫療器材管理法 第 25 條（全國法規資料庫）。law.moj.gov.tw pcode=L0030106 flno=25（取用 2026-08-06，HTTP 200，第 1 項逐字對得上）
  • S21 臺北市政府衛生局－收費標準：「臺北市醫療機構牙科收費標準表」(1090117核定)。health.gov.taipei 收費標準頁（取用 2026-08-06，ego-browser 實測可達，頁面標題與頁面文字逐字對得上）
  • S22 政府資料開放平臺 資料集「臺北市醫療收費標準」（資料集編號 121913）。data.gov.tw/dataset/121913（取用 2026-08-06，ego-browser 實測可達，標題逐字對得上）
  • S23 衛生福利部中央健康保險署「醫材比價網」自付差額醫材比價查詢頁與醫材收費比價查詢頁。info.nhi.gov.tw INAE2011S01、info.nhi.gov.tw INAE2012S01（實測紀錄見 F22；兩軌類別皆不含牙科，本卡引用其為「不可用作牙科查證管道」之依據）
  • S24 內部資料：`analysis/reports/km-dental-backlog.md` 第 24 題附錄（14 診所站 GSC 全量，資料窗 2025-03～2026-08），14 詞項跨 6 站，逐筆可對帳。非醫學事實 basis，僅為選題與熱詞依據。
  • S25 編輯框架（無外部來源）：本卡的三種情況分流、材料四類排列、費用六塊拆項與 checklist 結構，見 F24、F25。

內部引用鏈

  • 同族深入卡（分工對象）：補骨粉會有後遺症嗎？失敗了會怎樣？（KM-DENTAL-28，草稿）。術後併發症的三級分辨、紅旗徵象、併發症對骨增量結果的影響，以及吸菸與血糖控制等個人風險因素，全部在該卡；本卡只做一句摘述並指向該卡，兩卡共用 Cochrane 與台灣法規錨，逐字 span 一致。
  • 費用口徑教學卡：植牙一顆到底多少錢？沒有公定價，但你可以看懂報價單（KM-DENTAL-09，草稿）。補骨常出現在植牙報價的「骨處理」那一塊，該卡整理了報價單四塊拆項與對帳方法；兩卡共用醫療法第 21、22 條與健保法第 51 條錨，以及醫材比價網不含牙科的實測結論。
  • 拔牙後的自然癒合對照：拔牙的洞要多久才會長好？（KM-DENTAL-01，草稿）。齒槽脊保存要對照的「自然癒合」是什麼樣子、時間軸如何，見該卡。
發布閘門提醒：本卡為 draft，四語（zh-Hans／en／ja）未產前不得進 km_entries。F7 的醫療器材許可證線上查詢介面本次未能實測取得（DNS 無法解析），該段維持「向院所索取書面產品品名」的寫法，禁改寫成任何線上查詢指引；F21 未逐項確認臺北市收費標準表是否列有骨移植相關處置，該連結僅作為「收費由縣市核定」的制度例證。

FAQ

骨粉是別人的骨頭嗎？
**要看是哪一類。** 臨床研究中的骨移植材料分為自體骨（取自病人自己）、同種異體骨（來自人類捐贈者的處理骨材）、異種骨（其他物種來源，研究中常見牛源）與合成材料四類[F8·S1][F10·S3]。上顎竇增高術的長期回顧把「單用自體骨」與「使用骨替代材料」並列比較[F13·S6]。要用哪一類由醫師依你的缺損型態與治療計畫判斷，你可以要求把材料寫進書面文件[F7·S20]。
骨粉は他人の骨ですか？ — **どの種類かによります。** 臨床研究での骨移植材は、自家骨（患者自身）、同種異体骨（ヒトのドナー由来の処理骨材）、異種骨（他種由来で研究ではウシ由来が多い）、合成材料の四類です [F8·S1][F10·S3]。上顎洞底挙上の長期レビューは、自家骨単独と骨代替材を並べて比較しています [F13·S6]。どれを使うかは欠損形態と治療計画で歯科医師が判断し、材料を書面に記すよう求められます [F7·S20]。
Is “bone powder” someone else's bone? — **It depends on the category.** Clinical research classifies graft material as autologous bone (from the patient), allograft (processed material from human donors), xenograft (from another species, commonly bovine-derived in studies), and synthetic material [F8·S1][F10·S3]. Long-term reviews of maxillary sinus floor elevation compare autologous bone alone with bone-substitute material [F13·S6]. The dentist chooses the category from the defect pattern and treatment plan, and you may ask for the material to be documented in writing [F7·S20].
可以不補骨粉嗎？
**在部分情況下，文獻確實顯示「不填」也有相近結果，但這不是可以自己決定的事。** 上顎竇增高術的隨機對照試驗統合分析（17 篇研究、547 個上顎竇、696 支植體）顯示，不使用骨移植材料與傳統填補在短期植體存活率上沒有統計上顯著差異；傳統作法的竇內增骨量較多，但作者指出這並非植體存活的決定因素[F14·S7]。同一份研究的結論同時要求謹慎解讀，理由是證據強度中等且追蹤期短[F14·S7]。至於拔牙後要不要做齒槽脊保存，Cochrane 的判定是「可能減少六個月時的脊高度與寬度變化，但證據非常不確定」[F8·S1]。是否適用，須由牙醫師依你的情況評估。
骨移植をしないことはできますか？ — **一部の状況では、充填しない場合にも近い結果を示す文献があります。ただし自分だけで決めることではありません。** 上顎洞底挙上のランダム化比較試験のメタ解析（17 研究、547 上顎洞、696 インプラント）では、骨移植材なしと従来の充填で短期インプラント生存率に統計学的有意差はありませんでした。従来法は洞内の骨増加量が多かったものの、著者はそれがインプラント生存を決める因子ではないとしました [F14·S7]。根拠の強さは中等度、追跡は短いため慎重な解釈が必要です [F14·S7]。抜歯後の歯槽堤保存については、6 か月時の高さと幅の変化を減らす可能性がある一方、根拠は非常に不確実です [F8·S1]。適用は歯科医師が評価します。
Can I choose not to have a bone graft? — **In some situations, the literature does find similar results without filling, but this is not a decision to make alone.** A meta-analysis of randomized controlled trials of maxillary sinus floor elevation (17 studies, 547 sinuses, 696 implants) found no statistically significant difference in short-term implant survival between no graft material and conventional filling. Conventional treatment produced more endo-sinus bone gain, but the authors said this was not a determinant of implant survival [F14·S7]. The same study requires cautious interpretation because the evidence strength was moderate and follow-up short [F14·S7]. For post-extraction alveolar ridge preservation, Cochrane concluded that it “may minimize” ridge-height and ridge-width changes at six months, but the evidence is very uncertain [F8·S1]. A dentist must assess whether it applies to you.
補進去的骨粉會變成自己的骨頭嗎？
**「維持外形」與「長出新骨」在文獻裡是兩個不同的指標。** 納入 88 篇隨機對照試驗的網絡統合分析顯示，維度保存排序居前的材料，組織學結果反而較差；而血小板濃縮製劑在新生骨百分比上表現較佳[F10·S3]。水平骨增生的統合分析也記錄到，移植材料吸收比例與病人年齡相關，且異種骨加在自體骨上比單用自體骨吸收較少[F11·S4]。所以不能簡化成「補了就會全部變成自己的骨頭」；實際結果因人而異，須由牙醫師以影像評估。
入れた骨移植材は自分の骨になりますか？ — **「形を保つ」と「新しい骨ができる」は文献上別の指標です。** 88 件のランダム化比較試験のネットワークメタ解析では、形態保存順位が上の材料で組織学的結果が悪く、血小板濃縮製剤は新生骨割合でより良好でした [F10·S3]。水平的骨造成のメタ解析でも、吸収割合は年齢と関連し、自家骨への異種骨追加は自家骨単独より吸収が少ないと記録されました [F11·S4]。したがって「入れれば全部自分の骨になる」と単純化できません。結果は人により異なり、歯科医師が画像で評価します。
Will the graft material become my own bone? — **“Maintaining the shape” and “forming new bone” are two different measures in the literature.** A network meta-analysis of 88 randomized controlled trials found that materials ranking toward the top in dimensional preservation had worse histological outcomes, while platelet concentrates performed better in the percentage of new bone formation [F10·S3]. The lateral bone-augmentation meta-analysis also recorded that graft-material resorption proportion was associated with patient age and that xenograft added to autologous bone had less resorption than autologous bone alone [F11·S4]. It cannot therefore be simplified to “all of it becomes your own bone.” Results vary by person and require imaging assessment by a dentist.

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引用本文

km 編輯部・《補骨粉是什麼？費用多少、會痛嗎？｜證據鏈》・IDAEO 知識庫・2026-08-13・https://km.idaeo.ai/reports/dental-bone-graft-basics-evidence

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更新 2026-08-13T14:17:05.102Z · server-rendered · four-language · IDAEO 知識庫