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使用自体块状骨移植和胶原膜引导骨再生技术进行水平嵴增量:42例患者的临床研究

Horizontal ridge augmentation using autogenous block grafts and the guided bone regeneration technique with collagen membranes: a clinical study with 42 patients.

作者信息

von Arx Thomas, Buser Daniel

机构信息

Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Berne, Berne, Switzerland.

出版信息

Clin Oral Implants Res. 2006 Aug;17(4):359-66. doi: 10.1111/j.1600-0501.2005.01234.x.

Abstract

OBJECTIVE

To analyze the clinical outcome of horizontal ridge augmentation using autogenous block grafts covered with an organic bovine bone mineral (ABBM) and a bioabsorbable collagen membrane.

MATERIAL AND METHODS

In 42 patients with severe horizontal bone atrophy, a staged approach was chosen for implant placement following horizontal ridge augmentation. A block graft was harvested from the symphysis or retromolar area, and secured to the recipient site with fixation screws. The width of the ridge was measured before and after horizontal ridge augmentation. The block graft was subsequently covered with ABBM and a collagen membrane. Following a tension-free primary wound closure and a mean healing period of 5.8 months, the sites were re-entered, and the crest width was re-assessed prior to implant placement.

RESULTS

Fifty-eight sites were augmented, including 41 sites located in the anterior maxilla. The mean initial crest width measured 3.06 mm. At re-entry, the mean width of the ridge was 7.66 mm, with a calculated mean gain of horizontal bone thickness of 4.6 mm (range 2-7 mm). Only minor surface resorption of 0.36 mm was observed from augmentation to re-entry.

CONCLUSIONS

The presented technique of ridge augmentation using autogenous block grafts with ABBM filler and collagen membrane coverage demonstrated successful horizontal ridge augmentation with high predictability. The surgical method has been further simplified by using a resorbable membrane. The hydrophilic membrane was easy to apply, and did not cause wound infection in the rare instance of membrane exposure.

摘要

目的

分析使用自体块状骨移植并覆盖有机牛骨矿物质(ABBM)和生物可吸收胶原膜进行水平牙槽嵴增高术的临床效果。

材料与方法

42例严重水平骨萎缩患者,采用分期方法在水平牙槽嵴增高术后植入种植体。从颏联合或磨牙后区获取块状骨,并用固定螺钉固定于受植区。在水平牙槽嵴增高术前和术后测量牙槽嵴宽度。随后在块状骨移植上覆盖ABBM和胶原膜。在无张力一期缝合伤口且平均愈合期为5.8个月后,再次切开术区,在植入种植体前重新评估嵴宽度。

结果

共增高58个部位,其中41个部位位于上颌前部。初始平均嵴宽度为3.06mm。再次切开时,牙槽嵴平均宽度为7.66mm,计算得出水平骨厚度平均增加4.6mm(范围2 - 7mm)。从增高到再次切开仅观察到0.36mm的轻微表面吸收。

结论

所介绍的使用自体块状骨移植、ABBM填充剂和胶原膜覆盖的牙槽嵴增高技术显示出成功的水平牙槽嵴增高,具有高度可预测性。通过使用可吸收膜进一步简化了手术方法。亲水性膜易于应用,在罕见的膜暴露情况下不会引起伤口感染。

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