Barone Antonio, Varanini Paolo, Orlando Bruno, Tonelli Paolo, Covani Ugo
Unit of Oral Pathology and Medicine, University of Genova, Genova, Italy.
J Oral Maxillofac Surg. 2009 Jun;67(6):1300-6. doi: 10.1016/j.joms.2008.12.043.
The purpose of this article was to evaluate the suitability of deep-frozen allograft for ridge augmentation procedures in severely atrophic maxillae and to evaluate the clinical success of dental implants inserted after grafting and before prosthetic rehabilitation.
This study included 13 patients (3 men and 10 women) aged 36 to 65 years. All the patients selected for this study required bone augmentation procedures because of severe alveolar ridge atrophy and were scheduled for onlay bone allograft and titanium implants in a 2-stage procedure. The dental implants were inserted 5 months after grafting. The follow-up period for the implants was 6 months after placement at the second stage of implant surgery.
A total of 24 onlay block allografts were used to augment atrophic maxillae in 13 patients. Of the 24 onlay block allografts, 5 were scheduled for vertical alveolar ridge augmentation and the remaining 19 for horizontal alveolar ridge augmentation. Early exposure of the onlay bone graft was observed in 2 patients. All the block grafts showing early exposure had to be completely removed because of infection. All the observed complications were associated with onlay bone grafts placed to increase the vertical dimension of the alveolar ridges. Thirty-eight implants ranging in length from 10 to 15 mm were placed in the area of bone augmentation. All implants inserted achieved satisfactory primary stability. Two implants failed to integrate 6 months after placement during the second stage of surgery. The failed implants were successfully replaced without any need for additional bone grafting.
The use of block allografts to treat maxillary atrophy yielded successful outcomes. Moreover, the augmentation procedure allowed the insertion of implants in the grafted area 5 months after surgery. Therefore, on the basis of this preliminary study, deep-frozen bone allograft can be considered a promising treatment for severe maxillary atrophy, with more extensive follow-up studies being needed to confirm these preliminary data.
本文旨在评估深冻同种异体骨用于严重萎缩上颌骨骨增量手术的适用性,并评估植骨后及修复前植入牙种植体的临床成功率。
本研究纳入13例年龄在36至65岁之间的患者(3例男性和10例女性)。所有入选本研究的患者因严重牙槽嵴萎缩均需要进行骨增量手术,并计划分两阶段进行覆盖式骨移植和钛种植体植入。牙种植体在植骨后5个月植入。种植体的随访期为种植手术第二阶段植入后6个月。
共使用24块覆盖式块状异体骨对13例患者的萎缩上颌骨进行骨增量。在这24块覆盖式块状异体骨中,5块用于垂直牙槽嵴增高,其余19块用于水平牙槽嵴增高。2例患者出现覆盖式骨移植早期暴露。所有出现早期暴露的块状移植骨因感染均需完全移除。所有观察到的并发症均与为增加牙槽嵴垂直尺寸而放置的覆盖式骨移植有关。在骨增量区域植入了38枚长度为10至15毫米的种植体。所有植入的种植体均获得了满意的初期稳定性。在手术第二阶段植入6个月后,有2枚种植体未能成功整合。失败的种植体成功更换,无需额外植骨。
使用块状异体骨治疗上颌骨萎缩取得了成功的结果。此外,骨增量手术允许在术后5个月在植骨区域植入种植体。因此,基于这项初步研究,深冻同种异体骨可被认为是治疗严重上颌骨萎缩的一种有前景的方法,但需要更广泛的随访研究来证实这些初步数据。