A Novel Combined Surgical Approach to Vertical Alveolar Ridge Augmentation with Titanium Mesh, Resorbable Membrane, and rhPDGF-BB: A Retrospective Consecutive Case Series
A Novel Combined Surgical Approach to Vertical Alveolar Ridge Augmentation with Titanium Mesh, Resorbable Membrane, and rhPDGF-BB: A Retrospective Consecutive Case Series
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DOI：
10.11607/prd.1460
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发表时间：
2013-07-01
影响因子：
1.6
通讯作者：
Moroi, Hidetada
中科院分区：
文献类型：
--
作者：
Funato, Akiyoshi;Ishikawa, Tomohiro;Moroi, Hidetada
本病例系列的目的是报告使用钛网、可吸收胶原膜和重组人血小板衍生生长因子BB（rhPDGF-BB）组合进行垂直牙槽嵴提升的临床结局和组织学发现。19名患者被纳入，并使用自体骨和无机牛骨颗粒。将骨移植物与rhPDGF-BB混合，并加载到骨缺损上，直到相邻牙槽嵴的水平。将预适应的钛网放置在移植区域上，并用可吸收胶原蛋白膜覆盖，使移植区域无任何区域暴露。17例患者表现出良好的软组织愈合。术后皮瓣裂开发生在愈合期相对较早的一个病人，而在另一个愈合期的后期阶段，覆盖的胶原蛋白膜暴露。在取出钛网的再入手术中，3名软硬组织愈合良好的患者接受了骨活检，对钛网下方的增强组织进行了组织学评价。增强骨的平均垂直高度为8.6 +/- 4.0 mm。本报告证明了使用钛网、可吸收胶原膜和rhPDGF组合进行引导骨再生用于垂直牙槽嵴增强的显著疗效，从而扩大了种植体治疗的适应症，并允许在严重吸收的牙槽嵴中恢复三维美学结构。
The purpose of this case series was to report the clinical outcomes and histologic findings of vertical ridge augmentation using a combination of titanium mesh, resorbable collagen membrane, and recombinant human plateletderived growth factor BB (rhPDGF-BB). Nineteen patients were included, and autogenous bone and anorganic bovine bone particles were used. The bone graft was mixed with rhPDGF-BB and loaded onto the bony defect up to the level of the adjacent alveolar crest. A pre-adapted titanium mesh was placed over the grafted region and covered with a resorbable collagen membrane, leaving no areas of the grafted region exposed. Seventeen patients exhibited good soft tissue healing. Postoperative flap dehiscence occurred relatively early in the healing period in one patient, whereas the covering collagen membrane was exposed during the later phase of the healing period in another. During reentry surgery for removal of the titanium mesh, three patients with favorable soft and hard tissue healing underwent bone biopsies for histologic evaluation of the augmented tissue just below the titanium mesh. The mean vertical height of augmented bone was 8.6 +/- 4.0 mm. This report demonstrates the remarkable efficacy of guided bone regeneration using a combination of titanium mesh, resorbable collagen membrane, and rhPDGF for vertical ridge augmentation, thus expanding the indications for implant therapy and allowing recovery of the three-dimensional esthetic architecture in a severely absorbed alveolar ridge.