Tang Zhi-hui, Lv Hong, Cao Mei-xia, Wu Min-jie
Second Dental Center, Peking University School and Hospital of Stomatology, Beijing 100081, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2010 Feb 18;42(1):94-7.
To evaluate the treatment effects of the half-columnar shaped mandibular block bone onlay grafting technique for augmentation of the resorbed maxillary anterior alveolar ridge after single tooth missing.
A total of 15 sites of 14 patients received ridge augmentation surgeries. The recipient sites were prepared with trephines, the half-columnar shaped bone blocks were harvested from the ramus and external oblique ridges with trephines according to diameters of the recipient sites. The bone blocks were placed as lateral onlay grafts on recipient beds and secured by means of titanium screws. Particulate bone was added and absorbable membranes were used to stabilize and protect the grafts. After a mean interval of 4.5 months of healing the flaps were re-opened, the screws were removed and non-submerged implants were placed. The width and height of the alveolar ridges were recorded. After 3 months, implant-supported crowns were provided to the patients. One year later, the peri-impant condition and the marginal bone resorption on the proximal sites were observed.
Mean lateral augmentation obtained at the time of bone grafting was (3.8 + or - 0.8) mm, 5 out of 15 sites exhibited a mean of 3 mm of vertical augmentation. The mean healing time was 4.5 months, the mean percentage of horizontal and vertical bone resorption in the mean time were 8% and 7% respectively. No major complications were recorded at donor sites. No implant was lost during the study period. Clinical parameters and probing depth (< or = 4 mm) demonstrated the presence of a healthy peri-implant mucosa after 1 year of prosthetic reconstruction. The clinical and radiographic bone observations showed no more than 1.2 mm of resorption after bone graft and implant placement.
The half-columnar shaped mandibular bone graft (from the ramus and external oblique ridge) is a promising technique for bone augmentation in localized alveolar ridge defects after single tooth missing. This procedure offers easy access, good bone quantity for localized repair, low morbidity, decreased complaints of postoperative sensory disturbances or discomfort, minimal graft resorption, and a shorter healing time as compared with other methods for bone repair.
评估半柱状下颌骨块外置植骨技术用于单颗牙缺失后上颌前牙区牙槽嵴吸收增高的治疗效果。
14例患者共15个位点接受了牙槽嵴增高手术。用环钻制备受植区，根据受植区直径用环钻从下颌升支和外斜线采集半柱状骨块。将骨块作为外侧植骨块置于受植床上，并用钛钉固定。添加颗粒骨并用可吸收膜稳定和保护植骨块。平均愈合4.5个月后翻开瓣，取出螺钉并植入非潜入式种植体。记录牙槽嵴的宽度和高度。3个月后为患者安装种植体支持的牙冠。1年后，观察种植体周围情况及近中位点的边缘骨吸收情况。
植骨时平均侧向增高为(3.8±0.8)mm，15个位点中有5个位点平均垂直增高3mm。平均愈合时间为4.5个月，在此期间水平和垂直骨吸收平均百分比分别为8%和7%。供区未记录到严重并发症。研究期间无种植体丢失。修复重建1年后的临床参数和探诊深度（≤4mm）表明种植体周围黏膜健康。临床和影像学骨观察显示植骨和种植体植入后骨吸收不超过1.2mm。
（取自下颌升支和外斜线的）半柱状下颌骨移植是单颗牙缺失后局部牙槽嵴缺损骨增高的一种有前景的技术。与其他骨修复方法相比，该手术操作简便，局部修复骨量充足，发病率低，术后感觉障碍或不适主诉减少，植骨吸收最小且愈合时间较短。
