Sohn Dong-Seok, Lee Hyun-Jin, Heo Jeung-Uk, Moon Jee-Won, Park In-Suk, Romanos Georgios E
Department of Dentistry and Oral and Maxillofacial Surgery, Catholic University Hospital of Daegu, Daegu, Republic of Korea.
J Oral Maxillofac Surg. 2010 Sep;68(9):2283-90. doi: 10.1016/j.joms.2010.04.009. Epub 2010 Jun 26.
The lateral ridge expansion technique is used to expand the narrow edentulous ridge for implant placement. The staged approach can be used to split the mandibular ridge to decrease the risk of malfracture during osteotomy. The present study reports the clinical results of a surgical technique that expands a narrow mandibular ridge using an immediate and a delayed lateral expansion technique.
A total of 32 patients with a narrow edentulous posterior mandibular ridge of 2 to 4 mm were included in the present study, and 84 implants were placed. Of the 32 patients, 23 were treated with an immediate lateral expansion technique and 9 with a delayed lateral expansion technique.
Of the 23 patients who underwent the immediate lateral expansion technique, a malfracture of the thin buccal cortical plate occurred during ridge splitting in 5 patients. All buccal segments of the 9 patients who underwent the delayed lateral expansion technique fractured as planned at the inferior horizontal corticotomy line favorably. After 4 to 5 months, all implants were stable and surrounded by bone, and ossification of the osteotomy line was obvious.
The lateral ridge expansion technique is effective for horizontal augmentation in the severely atrophic posterior mandibular ridge. The delayed lateral ridge expansion technique can be used more safely and predictably in patients with high bone quality and thick cortex and a narrower ridge in the mandible.
侧方牙槽嵴扩展技术用于扩展狭窄的无牙颌牙槽嵴以植入种植体。分期方法可用于劈开下颌牙槽嵴以降低截骨术中骨折不良的风险。本研究报告了一种使用即刻和延迟侧方扩展技术扩展狭窄下颌牙槽嵴的手术技术的临床结果。
本研究共纳入32例下颌后牙区无牙颌牙槽嵴狭窄（2至4毫米）的患者，共植入84枚种植体。32例患者中，23例采用即刻侧方扩展技术治疗，9例采用延迟侧方扩展技术治疗。
在采用即刻侧方扩展技术的23例患者中，5例在牙槽嵴劈开过程中发生薄颊侧皮质骨板骨折。采用延迟侧方扩展技术的9例患者的所有颊侧骨段均按计划在下水平截骨线处顺利骨折。4至5个月后，所有种植体均稳定且被骨组织包围，截骨线的骨化明显。
侧方牙槽嵴扩展技术对严重萎缩的下颌后牙区牙槽嵴的水平增高有效。延迟侧方牙槽嵴扩展技术可更安全、可预测地用于骨质良好、皮质厚且下颌牙槽嵴较窄的患者。
