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[钛箔下方的引导性骨再生]

[Guided bone regeneration beneath titanium foils].

作者信息

Otto Katharina, Schopper Christian, Ewers Rolf, Lambrecht J Thomas

机构信息

Poliklinik für zahnärztliche Prothetik und Werkstoffkunde, Zentrum für Zahn-, Mund- und Kieferheilkunde der Universität Leipzig.

出版信息

Schweiz Monatsschr Zahnmed. 2004;114(10):996-1002.

Abstract

The aim of this study was to examine the clinical and histological bony healing process beneath titanium foils used for guided tissue regeneration as well as of the Frios Algipore graft which was applied with autologous bone. 66 sinus floor elevations were carried out and examined over a period of three years and eight months. A success rate of 64% was recorded with foil incorporation. Complications occurred in form of primary and secondary disturbances in the healing process caused by exposure of the foil. 12 of the 66 foils had to be removed early. In all but one case, the augmented bone material was macroscopically well integrated despite the loss of the foil. Primary stability of the inserted dental implants into the ossified augmented site after operations of the sinus maxillaris was reached in all cases with absence of post-operative complications, and in 94% when there was postoperative exposure of the membrane. Histologically, a thin layer of connective tissue poor in cells but rich in collagen fibers appeared underneath the titanium foil. This was followed by newly-formed bony tissue transforming into osseous lamella parallel to the membrane underneath the new periost. In 65 out of 66 cases a sufficient amount of stable bone was built up locally suggesting good bio-compatibility and barrier function. Further, the foil also provided mechanical rest and supporting function for the space underneath. However, the occurrence of healing complications in 36% of the cases showed a need to improve on the titanium foils.

摘要

本研究的目的是检查用于引导组织再生的钛箔下方以及与自体骨一起应用的弗里斯藻酸盐移植材料下方的临床和组织学骨愈合过程。在三年零八个月的时间里进行并检查了66次上颌窦底提升术。钛箔植入的成功率为64%。并发症表现为钛箔暴露导致的愈合过程中的原发性和继发性干扰。66片钛箔中有12片不得不提前取出。除1例之外,尽管钛箔丢失,但增强的骨材料在宏观上整合良好。在上颌窦手术之后,所有病例中植入牙种植体至骨化增强部位均达到了初期稳定性,且无术后并发症;当膜出现术后暴露时,这一比例为94%。组织学上,钛箔下方出现一层细胞稀少但富含胶原纤维的结缔组织。随后,新形成的骨组织转变为与新骨膜下方的膜平行的骨板。66例中的65例在局部形成了足够量的稳定骨,表明具有良好的生物相容性和屏障功能。此外,钛箔还为下方的空间提供了机械支撑和支持功能。然而,36%的病例出现愈合并发症表明需要对钛箔进行改进。

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