Clinical results of alveolar ridge augmentation with mandibular block bone grafts in partially edentulous patients prior to implant placement
Clinical results of alveolar ridge augmentation with mandibular block bone grafts in partially edentulous patients prior to implant placement
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DOI：
10.1034/j.1600-0501.2002.130113.x
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发表时间：
2002-02-01
影响因子：
4.3
通讯作者：
Cordaro, M
中科院分区：
文献类型：
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作者：
Cordaro, L;Amadè, DS;Cordaro, M
一组 15 名部分无牙颌患者需要进行牙槽嵴增量以进行种植体植入，他们在门诊环境中连续使用两阶段技术进行治疗。总共移植了 18 个牙槽段。在第一次手术中，将从下颌升支或联合处采集的骨块作为横向或垂直嵌体移植物放置，并在暴露有缺陷的牙槽嵴后用钛骨缝合螺钉固定。愈合 6 个月后，皮瓣重新打开，取出螺钉并放置种植体。第一次手术后十二个月，可以为患者提供种植体支撑的固定桥。骨移植时获得的平均横向增量为 6.5+/-0.33 毫米，在愈合过程中由于移植物吸收而减少至平均 5.0+/-0.23 毫米。在 9 个需要的部位获得的平均垂直增量在骨移植时为 3.4+/-0.66 毫米，在种植体植入时为 2.2+/-0.66 毫米。在骨移植愈合期间（种植体植入前），平均横向和纵向增量分别减少了 23.5% 和 42%。下颌部位比上颌部位显示出更多的骨移植吸收量。所有 40 个种植体均在修复体装载后在基台连接处整合（平均随访时间为 12 个月）。供体或受体部位没有记录到严重并发症。软组织愈合顺利，疼痛和肿胀与通常的牙槽手术相当。当从下颌联合处取出骨头时，可见的瘀斑会持续 4 至 7 天。从临床角度来看，该手术对于治疗部分无牙颌患者的局部牙槽嵴缺损似乎简单、安全且有效。
A group of 15 partially edentulous patients who needed alveolar ridge augmentation for implant placement, were consecutively treated using a two-stage technique in an outpatient environment. A total of 18 alveolar segments were grafted. During the first operation bone blocks harvested from the mandibular ramus or symphysis were placed as lateral or vertical onlay grafts and fixed with titanium osteosynthesis screws after exposure of the deficient alveolar ridge. After 6 months of healing the flap was re-opened, the screws were removed and the implants placed. Twelve months after the first operation implant-supported fixed bridges could be provided to the patients. Mean lateral augmentation obtained at the time of bone grafting was 6.5+/-0.33 mm, that reduced during healing because of graft resorption to a mean of 5.0+/-0.23 mm. Mean vertical augmentation obtained in the 9 sites where it was needed was 3.4+/-0.66 mm at bone grafting and 2.2+/-0.66 mm at implant placement. Mean lateral and vertical augmentation decreased by 23.5% and 42%, respectively, during bone graft healing (before implant insertion). Mandibular sites showed a larger amount of bone graft resorption than maxillary sites. All the 40 implants placed were integrated at the abutment connection and after prosthetic loading (mean follow-up was 12 months). No major complications were recorded at donor or recipient sites. Soft tissue healing was uneventful, and pain and swelling were comparable to usual dentoalveolar procedures. A visible ecchymosis was present for 4 to 7 days when the bone was harvested from the mandibular symphysis. From a clinical point of view this procedure appears to be simple, safe and effective for treating localised alveolar ridge defects in partially edentulous patients.