von Arx T, Cochran D L, Hermann J S, Schenk R K, Buser D
Department of Oral Surgery, School of Dental Medicine, University of Berne, Switzerland.
Clin Oral Implants Res. 2001 Jun;12(3):260-9. doi: 10.1034/j.1600-0501.2001.012003260.x.
Lateral ridge augmentation has become a standard treatment option to enhance the bone volume of deficient recipient sites prior to implant placement. In order to avoid harvesting an autograft and thereby eliminating additional surgical procedures and risks, bone grafting materials and substitutes are alternative filler materials to be used for ridge augmentation. Before clinical recommendations can be made, such materials must be extensively studied in experimental models simulating relevant clinical situations. The present pilot study was conducted in three dogs. Different grafting procedures were evaluated for augmentation of lateral, extended (8 x 10 x 14 mm) and chronic bone defects in the mandibular alveolar ridge. Experimental sites received tricalcium phosphate (TCP) granules or demineralized freeze-dried bone allograft (DFDBA) particles. Barrier membranes (ePTFE) were placed for graft protection. These approaches were compared to ridge augmentation using autogenous cortico-cancellous block grafts, either with or without ePTFE-membrane application. After a healing period of six months, the sites were analyzed histologically and histomorphometrically. Autografted sites with membrane protection showed excellent healing results with a well-preserved ridge profile, whereas non-protected block grafts underwent bucco-crestal resorption, clearly limiting the treatment outcome. The tested alloplastic (TCP) and allogenic (DFDBA) filler materials presented inconsistent findings with sometimes encapsulation of particles in connective tissue, thereby reducing the crestal bone width. The present pilot study supports the use of autografts with barrier membranes for lateral ridge augmentation of extended alveolar bone defects.
在种植体植入前，侧方牙槽嵴增高术已成为增加骨量不足的受体部位骨量的标准治疗选择。为了避免采集自体骨，从而消除额外的手术程序和风险，骨移植材料和替代物是用于牙槽嵴增高的替代填充材料。在做出临床推荐之前，此类材料必须在模拟相关临床情况的实验模型中进行广泛研究。本初步研究在三只犬身上进行。评估了不同的移植程序用于下颌牙槽嵴外侧、扩展型（8×10×14毫米）和慢性骨缺损的增高。实验部位接受磷酸三钙（TCP）颗粒或脱矿冻干骨同种异体移植（DFDBA）颗粒。放置屏障膜（ePTFE）以保护移植材料。将这些方法与使用自体皮质松质骨块状移植进行牙槽嵴增高的方法进行比较，后者使用或不使用ePTFE膜。经过六个月的愈合期后，对这些部位进行组织学和组织形态计量学分析。有膜保护的自体移植部位显示出良好的愈合效果，牙槽嵴轮廓保存良好，而未受保护的块状移植则发生颊侧牙槽嵴吸收，明显限制了治疗效果。所测试的人工合成（TCP）和同种异体（DFDBA）填充材料的结果不一致，有时颗粒会被结缔组织包裹，从而减小牙槽嵴骨宽度。本初步研究支持使用带有屏障膜的自体骨用于扩展型牙槽骨缺损的侧方牙槽嵴增高。
