Laverick S, Summerwill A, Cawood J I
Department of Oral & Maxillofacial Surgery, Countess of Chester Hospital, Chester, UK.
Int J Oral Maxillofac Surg. 2008 May;37(5):415-8. doi: 10.1016/j.ijom.2007.12.007. Epub 2008 Mar 4.
The anterior maxillary osteoplasty restores adequate bone to the edentulous Class IV ridge prior to placement of endosseous implants. The aim of this retrospective study was to compare the long-term survival of implants placed into the particulate bone of an anterior alveolar osteoplasty to those placed into a 'block' onlay bone graft. Of 85 patients with Class IV 'knife-edge' alveolar ridges, 50 received interpositional particulate bone via an alveolar osteoplasty and 35 received an onlay cortico-cancellous graft. A total of 386 implants were placed as a secondary procedure and followed postoperatively (mean 6 years; 39 failures). There was improved cumulative survival of implants placed into the particulate bone of an osteoplasty compared to the block bone of an onlay graft. Implants supporting a fixed superstructure had a longer cumulative survival than those supporting a removable appliance. There was no statistical difference between implants placed into male and female bone, or between those in edentulous and partially dentate jaws. Within a partially dentate jaw there was a statistically significant increase in cumulative survival for implants within osteoplasty inlay bone compared to onlay bone grafts. Anterior osteoplasty is the surgical treatment of choice for augmentation of the resorbed Class IV alveolar ridge prior to placement of osseo-integrated implants.
在上颌骨前部进行骨成形术，可在植入骨内种植体之前，为无牙的IV类牙槽嵴恢复足够的骨量。本回顾性研究的目的是比较植入前部牙槽骨成形术的颗粒状骨中的种植体与植入“块状”覆盖骨移植中的种植体的长期存活率。在85例IV类“刀刃状”牙槽嵴患者中，50例通过牙槽骨成形术接受了间置颗粒状骨，35例接受了皮质松质骨覆盖移植。总共植入了386颗种植体作为二期手术，并在术后进行随访（平均6年；39例失败）。与覆盖移植的块状骨相比，植入骨成形术颗粒状骨中的种植体的累积存活率有所提高。支持固定上部结构的种植体的累积存活率高于支持可摘矫治器的种植体。植入男性和女性骨中的种植体之间，以及植入无牙颌和部分牙列缺损颌骨中的种植体之间，均无统计学差异。在部分牙列缺损的颌骨中，与覆盖骨移植相比，骨成形术嵌体骨内种植体的累积存活率有统计学意义的提高。在上颌骨前部进行骨成形术是在植入骨整合种植体之前，对吸收的IV类牙槽嵴进行增量的手术治疗选择。
