Viscioni A, Dalla Rosa J, Paolin A, Franco M
Maxillofacial Surgery Unit, Castelfranco Veneto Hospital, Treviso, Italy.
J Ir Dent Assoc. 2010 Aug-Sep;56(4):186-91.
Although autologous bone is considered to be the gold standard grafting material, it needs to be harvested from patients, a process that can be off-putting and can lead to donor site morbidity. For this reason, homologous fresh-frozen bone (FFB) was used in the current study as an alternative graft material.
The aim of this study was to evaluate the effectiveness of FFB as a grafting material in complex maxillary sinus lift with immediate implant insertion.
FFB was obtained from the Veneto Tissue Bank and preserved at -80 degrees C. Twenty-one patients were surgically treated with FFB block grafts in 26 maxillary sinus rehabilitations, with 47 immediate implant insertions, with a reopening phase after six months. All patients underwent orthopanoramic X-rays and CT scans before, immediately after and four months (X-ray only) post surgery. Bone biopsies were performed in order to evaluate the volume and density of the bone grafts, which all showed optimal adherence without complications.
Four months post surgery, 64% of grafts showed no evidence of bone resorption or resizing. In all other cases resorption was slight. All implants were clinically osseointegrated, with only one implant failure during the provisional prosthetic loading stage (97.8% success rate). Histological studies confirmed these results, showing the presence of new bone and sparse osteoclastic activity four months post implantation, with 80% mature bone material observed after 12 months.
Use of FFB permits effective bone-adding surgery and immediate implant insertion under local anaesthesia, decreasing both chair time and patient discomfort.
尽管自体骨被认为是金标准移植材料,但它需要从患者身上获取,这一过程可能令人却步,并可能导致供区并发症。因此,在本研究中使用了同种异体新鲜冷冻骨(FFB)作为替代移植材料。
本研究的目的是评估FFB作为移植材料在复杂上颌窦提升同期即刻种植中的有效性。
FFB取自威尼托组织库并保存在-80℃。21例患者接受了FFB块状移植手术,共进行了26次上颌窦修复,即刻种植47颗,术后6个月进行复诊。所有患者在手术前、术后即刻和术后4个月(仅X线检查)均接受了全景X线片和CT扫描。进行骨活检以评估骨移植的体积和密度,所有结果均显示骨移植附着良好,无并发症。
术后4个月,64%的移植骨未见骨吸收或尺寸改变。在所有其他情况下,吸收均很轻微。所有种植体均实现了临床骨结合,在临时修复体加载阶段仅1颗种植体失败(成功率97.8%)。组织学研究证实了这些结果,显示植入后4个月有新骨形成且破骨细胞活性稀疏,12个月后观察到80%的成熟骨材料。
使用FFB可在局部麻醉下有效进行骨增量手术并同期即刻种植,减少了椅旁时间和患者不适。