Department of Maxillo-Facial Surgery, Faculty of Medicine-University of Florence, Italy.
J Craniomaxillofac Surg. 2010 Apr;38(3):222-30. doi: 10.1016/j.jcms.2009.07.004. Epub 2009 Aug 3.
Localized bone defects in the maxilla are commonly reconstructed with autologous mono-cortical bone blocks prior to the placement of dental implants. This study presents a clinical, histological and histomorphometric analysis on the use of mandibular ramus block grafts for ridge augmentation.
mono-cortical bone blocks from the mandibular ramus were grafted in 15 patients. The bone grafts were left to heal for period varying from 3 to 9 months. Afterwards, 30 implants were inserted and bone samples were removed for subsequent histological analysis.
All the bone grafts were successful and resorption was minimal. There were no implant failures. At graft placement, mean lateral augmentation was 4.6+/-0.73mm, which, later, at the time of implant insertion, reduced to 4+/-0.77mm. Histological evaluation indicated signs of active remodelling in all specimens. However, the grafted bone contained substantial amounts of non-vital bone (NVB) and generally weak neo-vascularization regardless of the time of biopsies.
The outcome of the study suggests that the larger part of osteocytes in mono-cortical bone do not survive grafting and neo-vascularization of non-vital grafted bone is difficult because of the slow remodelling process into new vital.
在植入牙种植体之前，通常使用自体单皮质骨块来重建上颌局限性骨缺损。本研究对下颌支骨块移植物用于牙槽嵴增高的临床、组织学和组织形态计量学分析。
从下颌支获得单皮质骨块，将其移植到 15 名患者中。骨移植物的愈合时间从 3 到 9 个月不等。之后，植入 30 个种植体，并取出骨样本进行随后的组织学分析。
所有的骨移植都很成功，吸收很少。没有种植体失败。在移植时，平均外侧增宽为 4.6+/-0.73mm，之后在植入种植体时减少到 4+/-0.77mm。所有标本均显示有活跃的改建迹象。然而，移植骨中含有大量的无活力骨（NVB），并且无论活检时间如何，新血管化通常都很弱。
研究结果表明，单皮质骨中的大部分成骨细胞在移植后不能存活，而且由于缓慢的改建过程，无活力的移植骨的新血管化很困难，难以形成新的有活力的骨。
