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植骨粉是什么？费用多少、会痛吗？｜證據鏈

km 編輯部2026-08-13阅读约 51 分钟
#證據鏈#牙醫KM#台灣#補骨

本頁是〈植骨粉是什么？费用多少、会痛吗？〉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。

植骨粉是什么？费用多少、会痛吗？｜證據鏈

F-Units（事实单元帐）

每条标明 confidence／basis／period／geo／逐字 span／caveat。basis 阶梯：law ＞ official_statement ＞ clinical_guideline ＞ peer_reviewed ＞ textbook。

  • F1｜confidence: verified｜basis: law（医疗法第 21 条，全国法规资料库 2026-08-06 实测 HTTP 200）｜period: 现行条文｜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: 条文本身不含任何金额，本卡不引用任何核定金额。
  • F2｜confidence: verified｜basis: law（医疗法第 22 条，2026-08-06 实测 HTTP 200）｜period: 现行条文｜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: 属收费行政规范，非个案法律意见。
  • F3｜confidence: verified｜basis: law（医疗法第 63 条，2026-08-06 实测 HTTP 200）｜period: 现行条文｜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: 引用其告知与同意规范，未就个案效力作法律判断。
  • F4｜confidence: verified｜basis: law（医疗法第 81 条，2026-08-06 实测 HTTP 200）｜period: 现行条文｜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: 条文引述，非法律意见。
  • F5｜confidence: verified｜basis: law（医疗法第 87 条第 2 项，2026-08-06 实测 HTTP 200）｜period: 现行条文｜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: 本条为本卡合规注记之定位依据。
  • F6｜confidence: verified｜basis: law（全民健康保险法第 51 条第 11 款，2026-08-06 实测 HTTP 200）｜period: 现行条文｜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: 条文列举的是不给付项目；植骨相关处置之给付与否以健保署现行公告为准，本卡不作给付判定。同锚亦用于 KM-DENTAL-09 与 KM-DENTAL-28。
  • F7｜confidence: verified｜basis: law（医疗器械管理法第 25 条第 1 项，2026-08-06 实测 HTTP 200）｜period: 现行条文｜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: 本卡仅引用查验登记与许可证制度的存在，未对任何特定产品作核准状态之认定；本次检索未能取得可实测的官方许可证查询介面（info.fda.gov.tw 于 2026-08-06 本机 DNS 无法解析），故本卡不提供线上查证连结，只建议向院所索取书面产品品名。
  • F8｜confidence: verified｜basis: peer_reviewed（Cochrane systematic review，PMID 33899930，CD010176.pub3）｜period: 检索至 2021-03-19，2021 刊出；为 2015 年初版之更新版，2026-08-06 以 PubMed 依刊出日排序检索同题 Cochrane 条目，未见更新的 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: 证据确定性很低；不得改写为「植骨可以避免日后再植骨」。并发症样态仅作一句摘述，分级与红旗判准见 KM-DENTAL-28。同锚亦用于 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 检索，同主题较新者为 2022 年网络荟萃分析（见 F10），本条数值为对照「单纯拔牙」的合并效果来源｜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: 合并值为组间差异的群体估计，非个人可预期的毫米数；该文于 2020 年有勘误（J Clin Periodontol 47(1):129），本卡引用之数值段落未见更动。
  • F10｜confidence: verified｜basis: peer_reviewed（systematic review・network meta-analysis，PMID 34826029）｜period: 检索至 2021-03，2022 刊出；2026-08-06 检索，之后同题网络荟萃分析多为单一材料主题（如 2025 年自体牙本质颗粒），未见取代此篇的广谱更新版｜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: 网络荟萃分析的排序是研究层级的相对比较，不能外推为个人疗效；本卡不引用任何产品名称。
  • F11｜confidence: verified｜basis: peer_reviewed（systematic review・meta-analysis，PMID 30624791）｜period: 检索至 2018-05，2019 刊出；2026-08-06 检索，同临床问题另有 2023 年网络荟萃分析（PMID 37752820，已用于 KM-DENTAL-28），本条保留于材料与屏障膜的效果面｜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: 作者自陈证据品质很低至中等；「加膜没有显著差异」是该回顾在骨宽度增加量此一指标上的结果，不等于临床上不需要屏障膜。同锚亦用于 KM-DENTAL-09。
  • F12｜confidence: verified｜basis: clinical_guideline（共识报告与临床建议，PMID 31215112，XV European Workshop in Periodontology 第 3 组）｜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: 为共识层级文件，本卡仅引用其决策考量清单，未引用个别术式建议。
  • F13｜confidence: verified｜basis: peer_reviewed（systematic review・meta-analysis，PMID 30624789）｜period: 检索至 2018-05，2019 刊出；2026-08-06 检索，之后同题系统性回顾多聚焦特定材料或细胞治疗，未见取代此篇的长期效果更新版｜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: 限侧窗技术、残存骨高度 ≤6 毫米之人群；年失败率为群体估计，非个人风险。
  • F14｜confidence: verified｜basis: peer_reviewed（systematic review・meta-analysis with trial sequential analysis，PMID 38757030）｜period: 检索 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: 属临床决策层面的比较，非「患者可自行选择不填」的依据；追踪期短、证据强度中等。
  • F15｜confidence: verified｜basis: peer_reviewed（systematic review，PMID 40806953）｜period: 检索至 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: 仅 6 篇纳入、2 篇为随机对照试验，作者自陈品质偏低且有存活者偏误；不得改写为疼痛程度的承诺或比较。术后不适时程与并发症分级见 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: 为病例系列的术式描述，证据等级低，仅用于「文献中的骨增量手术在局部麻醉下进行」此一程序事实，不作疗效或疼痛程度推论；个别麻醉方式由牙医师依患者状况决定。
  • F17｜confidence: verified｜basis: peer_reviewed（systematic review・meta-analysis，PMID 31860134）｜period: 纳入 1990 至 2019 之随机对照试验，2020 刊出；为欧洲牙周病联盟 S3 指引之委托回顾之一，2026-08-06 检索，较新的同题证据见 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 毫米之骨内缺损，且仅 10 篇纳入研究被评为低偏误风险；不可外推为「所有摇动的牙齿植骨都有效」。
  • F18｜confidence: verified｜basis: peer_reviewed（systematic review・network meta-analysis，PMID 33289191）｜period: 纳入追踪 ≥3 年之随机对照试验，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: 作者明言牙齿丧失部分证据稀少且无法建立疗法优劣阶层，不得改写为疗效承诺。
  • F19｜confidence: verified｜basis: peer_reviewed（systematic review・meta-analysis，PMID 40897233）｜period: 检索至 2024-12-18，2025 刊出；为本卡牙周段中刊出年份较近的同题证据（检索日 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: 比较的是「生物制剂单用」与「生物制剂加骨移植材料」，不是「植骨对照不植骨」；差异幅度有限，且作者主张选择性使用。
  • F20｜confidence: verified｜basis: clinical_guideline（S3 等级临床实务指引，PMID 32383274，欧洲牙周病联盟）｜period: 2020 刊出（2021 年有勘误）｜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: 本卡仅引用其阶梯式治疗架构，未引用个别介入措施之推荐强度；台湾临床实务仍依主治牙医师判断与健保署规定。
  • F21｜confidence: verified｜basis: official_statement（台北市政府卫生局公告＋政府资料开放平台资料集）｜period: 1090117 核定；两页 2026-08-06 以 ego-browser 实测可达，页面标题逐字相符｜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: 仅为一个县市的已验例证，其他县市各自公告；本卡不引用其中任何金额，亦未逐项确认该表是否列有骨移植相关处置。
  • F22｜confidence: verified｜basis: official_statement（本站浏览器实测，2026-08-05 首验、2026-08-06 于 KM-DENTAL-09 复验，同锚）｜period: 实测当日状态｜geo: TW｜实测纪录: 健保署醫材比價網自付差额医材比价查询页（INAE2011S01）之医材类别 12 项、医材收费比价查询页（INAE2012S01）之手术及处置类别 8 项，两页 document.body.innerText 皆不含「牙」字，故牙科自费品项（含骨移植材料）无法由该网查证｜caveat: 为实测当日之资料状态，官方资料库可能更新，引用时请注明查证日期。本条为「不可用作查证管道」之否定性结论，不是价格资讯。
  • F23｜confidence: verified｜basis: internal_dataset（内部资料 GSC，非医学 basis；发布转档时整条不输出）｜period: 资料窗 2025-03～2026-08｜geo: TW｜本题查询族共 14 个词项、跨 6 个站，逐笔可对帐；选题证据数值保留于草稿 frontmatter 与内部档案，发布转档时不进可见层（2026-08-05 裁定）。
  • F24｜无外部来源｜结构性整理（编辑框架，非事实宣称）｜「三种情况」的分流、材料四类的排列、费用六块拆项、checklist 七题与本卡与 KM-DENTAL-28 的分工声明，均为本站为了让患者问对问题而定义的说明结构，不是官方分类，也不是临床指引。
  • F25｜无外部来源｜证据缺口声明（editorial，非待验）｜本卡不提供以下内容：①任何金额或价格区间（收费依各县市核定标准与院所报价而定） ②个人化的疗程天数或愈合月数（取决于缺损型态与治疗计划） ③术后并发症的分级与红旗判准（属 KM-DENTAL-28） ④任何骨移植材料或屏障膜的品牌比较（本次检索未取得可支持品牌层级结论的证据，且品牌比较不属卫教范围） ⑤保险理赔与契约条款之法律见解。

来源清单

PubMed 条目均于 2026-08-06 以 E-utilities efetch 取回摘要原文并逐字比对，条目页另以 HTTP 实测响应 200。

PubMed 条目均于 2026-08-06 以 E-utilities efetch 取回摘要原文并逐字比对，条目页另以 HTTP 实测回应 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。
  • 同族深入卡（分工对象）：植骨粉会有后遗症吗？失败了会怎样？（KM-DENTAL-28，草稿）。术后并发症的三级分辨、红旗征象、并发症对骨增量结果的影响，以及吸烟与血糖控制等个人风险因素，全部在该卡；本卡只做一句摘述并指向该卡，两卡共用 Cochrane 与台湾法规定锚，逐字 span 一致。
  • 费用口径教学卡：种种植一颗到底多少钱？没有公定价，但你可以看懂报价单（KM-DENTAL-09，草稿）。植骨常出现在种种植报价的“骨处理”那一块，该卡整理了报价单四块拆项与对账方法；两卡共用《医疗法》第 21、22 条与《全民健康保险法》第 51 条定锚，以及醫材比價網不含牙科的实测结论。
  • 拔牙后的自然愈合对照：拔牙的洞要多久才会长好？（KM-DENTAL-01，草稿）。牙槽嵴保存要对照的“自然愈合”是什么样子、时间轴如何，见该卡。
发布闸门提醒：本卡为 draft，zh-Hans／en／ja 未产前不得进入 km_entries。F7 的医疗器械许可证在线查询界面本次未能实测取得（DNS 无法解析），该段维持“向院所索取书面产品品名”的写法，禁止改写成任何在线查询指引；F21 未逐项确认台北市收费标准表是否列有骨移植相关处置，该链接仅作“收费由县市核定”的制度例证。

FAQ

骨粉是别人的骨头吗？
**要看是哪一类。** 临床研究中的骨移植材料分为自体骨（取自患者自己）、同种异体骨（来自人类捐赠者的处理骨材）、异种骨（其他物种来源，研究中常见牛源）与合成材料四类[F8·S1][F10·S3]。上颌窦增高术的长期回顾把「单用自体骨」与「使用骨替代材料」并列比较[F13·S6]。要用哪一类由牙医师依你的缺损型态与治疗计划判断，你可以要求把材料写进书面文件[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].
可以不植骨粉吗？
**在部分情况下，文献确实显示「不填」也有相近结果，但这不是可以自己决定的事。** 上颌窦增高术的随机对照试验荟萃分析（17 篇研究、547 个上颌窦、696 支植体）显示，不使用骨移植材料与传统填补在短期植体存留率上没有统计上显著差异；传统作法的窦内增骨量较多，但作者指出这并非植体存活的决定因素[F14·S7]。同一份研究的结论同时要求谨慎解读，理由是证据强度中等且追踪期短[F14·S7]。至于拔牙后要不要做牙槽嵴保存，Cochrane 的判定是「可能减少六个月时的脊高度与宽度变化，但证据非常不确定」[F8·S1]。是否适用，须由牙医师依你的情况评估。
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.
补进去的骨粉会变成自己的骨头吗？
**「维持外形」与「长出新骨」在文献里是两个不同的指标。** 纳入 88 篇随机对照试验的网络荟萃分析显示，维度保存排序居前的材料，组织学结果反而较差；而血小板浓缩制剂在新生骨百分比上表现较佳[F10·S3]。水平骨增量的荟萃分析也记录到，移植材料吸收比例与患者年龄相关，且异种骨加在自体骨上比单用自体骨吸收较少[F11·S4]。所以不能简化成「补了就会全部变成自己的骨头」；实际结果因人而异，须由牙医师以影像评估。
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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km 編輯部・《植骨粉是什么？费用多少、会痛吗？｜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