Inlay versus onlay iliac bone grafting in atrophic posterior mandible: a prospective controlled clinical trial for the comparison of two techniques.
Inlay versus onlay iliac bone grafting in atrophic posterior mandible: a prospective controlled clinical trial for the comparison of two techniques.
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DOI：
10.1111/j.1708-8208.2009.00212.x
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发表时间：
2009-10-01
影响因子：
3.6
通讯作者：
Marchetti, Claudio
中科院分区：
文献类型：
--
作者：
Felice, Pietro;Pistilli, Roberto;Marchetti, Claudio
目的：比较嵌体和嵌体植骨技术矫治下颌后牙萎缩的垂直成骨效果和种植效果。材料与方法：将20个手术部位分为嵌体和嵌体两组，供体为髂骨。术后3~4个月，43颗种植体植入，4个月后加载。结果：嵌体组和高嵌组的中位骨增长分别为4.9 mm和6.5 mm(p=.019)，中位骨吸收分别为0.5 mm和2.75 mm(p<；.001)，中位数垂直增大分别为4.1 mm和4 mm(p=.190)。两组种植成活率均为100%，种植成功率分别为90%和86.9%(p=0.190，无统计学意义)。两组的轻微和严重并发症发生率分别为20%和10%。结论：嵌体可以减少骨吸收，结果更可预测，但需要有经验的外科医生。相比之下，嵌合会导致更大的骨吸收，需要高度过大的骨块移植物，但需要较短的学习曲线。一旦进行了植入，两种手术的结果是相似的。
PURPOSE: To compare the efficacy of inlay and onlay bone grafting techniques in terms of vertical bone formation and implant outcomes for correcting atrophic posterior mandibles.MATERIALS AND METHODS: Twenty surgical sites were assigned to two treatment groups, inlay and onlay, with iliac crest as donor site. After 3 to 4 months, 43 implants were placed and loaded 4 months later. The median follow up after loading was 18 months.RESULTS: For the inlay versus onlay group, median bone gain was 4.9 versus 6.5 mm (p = .019), median bone resorption was 0.5 versus 2.75 mm (p < .001), and median final vertical augmentation was 4.1 versus 4 mm (p = .190). The implant survival rate was 100% in both groups, while the implant success rate was 90% versus 86.9% (p = .190, not significant). A minor and major complication rate of 20% and 10%, respectively, for both groups was encountered.CONCLUSIONS: Inlay results in less bone resorption and more predictable outcomes, but requires an experienced surgeon. In contrast, onlay results in greater bone resorption and requires a bone block graft oversized in height, but involves a shorter learning curve. Once implant placement has been carried out, the outcomes are similar for both procedures.