Gerressen Marcus, Hermanns-Sachweh Benita, Riediger Dieter, Hilgers Ralf-Dieter, Spiekermann Hubertus, Ghassemi Alireza
Department of Oral, Maxillofacial and Plastic Facial Surgery, University Hospital of the Aachen University (RWTH), Aachen, Germany.
Clin Oral Implants Res. 2009 Feb;20(2):109-15. doi: 10.1111/j.1600-0501.2008.01619.x. Epub 2008 Dec 1.
Among the different graft materials being applied in sinus elevation surgery autogenous bone, especially from the iliac crest, is considered to be the graft of choice. The goal of this prospective study was to investigate whether purely cancellous transplants of this donor site lead to significantly better results regarding bone quantity and quality when compared to corticocancellous iliac bone grafts.
Fifteen patients suffering from extreme maxillary atrophy underwent bilateral sinus floor augmentation with grafts from the iliac crest consisting of purely cancellous bone (PCB) for the right side and a mixture of 50% cancellous and 50% cortical bone for the left side, respectively. Bone samples that were taken during implant insertion were examined histologically for semiquantitative assessment. In addition, bone density was measured histomorphometrically. Data were statistically analyzed by a repeated measures analysis of covariance model and post hoc paired t-tests as well as Pearson's correlation analysis.
Semiquantitative analysis of bone quality resulted in comparable results for both graft preparations while bone density was significantly higher in the PCB group. Without consideration of the different transplant groups, there was neither a significant correlation between patients' age and bone density nor bone quality. Differences between the genders could not be observed either.
Because of better bone density, the PCB graft from the iliac crest remains our gold standard. Even in elderly patients, autogenous grafts can be utilized without losses in the properties of the resulting bone.
在鼻窦提升手术中应用的不同移植材料中，自体骨，尤其是取自髂嵴的自体骨，被认为是首选移植材料。本前瞻性研究的目的是调查与皮质松质髂骨移植相比，该供区的纯松质骨移植在骨量和骨质量方面是否能带来显著更好的效果。
15例患有严重上颌骨萎缩的患者接受了双侧鼻窦底提升术，右侧使用取自髂嵴的纯松质骨（PCB）移植，左侧使用50%松质骨和50%皮质骨的混合移植。在植入种植体时采集骨样本进行组织学检查以进行半定量评估。此外，采用组织形态计量学方法测量骨密度。数据通过重复测量协方差分析模型、事后配对t检验以及Pearson相关分析进行统计学分析。
骨质量的半定量分析显示两种移植制剂的结果相当，而PCB组的骨密度显著更高。不考虑不同的移植组，患者年龄与骨密度及骨质量之间均无显著相关性。也未观察到性别差异。
由于骨密度更高，取自髂嵴的PCB移植仍是我们的金标准。即使是老年患者，自体移植也可使用，且所形成骨的特性不会受损。
