Hölzle Frank, Bauer Florian, Kesting Marco R, Mücke Thomas, Deppe Herbert, Wolff Klaus-Dietrich, Swaid Sami
Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität München, Germany.
Br J Oral Maxillofac Surg. 2011 Oct;49(7):542-5. doi: 10.1016/j.bjoms.2010.10.002. Epub 2010 Oct 28.
Dental implants have played a part in rehabilitation of the jaws for more than 40 years, but in some cases they alone are inadequate because of extreme alveolar resorption. Correction may necessitate a two-stage procedure with additional interventions. We have made a preliminary study of the use of the Norian skeletal repair system (SRS), a carbonated calcium phosphate bone cement used to augment the alveolar ridge as a single-stage procedure, with the placement of implants. Ten edentulous patients with insufficient vertical bone in the interforaminal area were treated. After a horizontal osteotomy and crestal mobilisation of the alveolar ridge, implants were placed through the crestal part and fixed in the basal part of the mandible. Norian SRS was used to fill the gap created. The prostheses were inserted 3 months later. Forty implants were inserted. The follow up period was 60 months, and no fractures or dislocations developed. One of the implants was lost and there was one wound dehiscence, but no surgical intervention or revision was necessary. Radiographs showed good consolidation of the bony structure in all cases. We have described a reliable, single-stage procedure for augmentation and implantation in a highly atrophic alveolar crest. A 98% survival is comparable with those of other techniques. Further clinical trials are necessary to replicate these promising results.
牙种植体在颌骨修复中发挥作用已有40多年，但在某些情况下，由于牙槽骨严重吸收，仅靠牙种植体是不够的。矫正可能需要分两阶段进行并辅以其他干预措施。我们对Norian骨骼修复系统（SRS）的应用进行了初步研究，这是一种碳酸磷酸钙骨水泥，可作为单阶段手术用于增加牙槽嵴高度，并同时植入种植体。对10例孔间区域垂直骨量不足的无牙患者进行了治疗。在进行水平截骨术和牙槽嵴嵴顶松动后，通过嵴顶部分植入种植体并固定在下颌骨基部。使用Norian SRS填充所形成的间隙。3个月后植入假体。共植入40枚种植体。随访期为60个月，未发生骨折或脱位。有1枚种植体丢失，出现1例伤口裂开，但无需手术干预或翻修。X线片显示所有病例骨结构均良好愈合。我们描述了一种用于高度萎缩牙槽嵴增高和种植的可靠单阶段手术方法。98%的种植体存留率与其他技术相当。需要进一步的临床试验来重复这些令人鼓舞的结果。
