Department of ENT/Oral & Maxillofacial Surgery, NÄL Medical Centre Hospital, Trollhättan, Sweden.
Clin Implant Dent Relat Res. 2011 Dec;13(4):305-10. doi: 10.1111/j.1708-8208.2009.00221.x. Epub 2010 Nov 18.
Reconstruction of the atrophic maxillae with autogenous bone graft and jawbone-anchored bridges is a well-proven technique. However, the morbidity associated with the concept should not be neglected. Furthermore, the costs for such treatment, including general anesthesia and hospital stay, are significant. Little data are found in the literature with regard to a cost-benefit approach to various treatment alternates.
The aim of this retrospective study was to compare from a health-economical and clinical perspective the reconstruction of the atrophic maxillae prior to oral implant treatment either with autogenous bone grafts harvested from the iliac crest or the use of demineralized freeze-dried bone (DFDB) in combination with a thermoplastic carrier (Regeneration Technologies Inc., Alachua, FL, USA) and guided bone regeneration (GBR).
A total of 26 patients (13 + 13) were selected and matched with regard to indication, sex, and age. The study was performed 5 years after the completion of the treatment. Implant survival, morbidity, and complications were analyzed. Furthermore, a detailed analysis of the total cost for the respective treatment modality was performed, including material, costs for staff, sick leave, etc.
The study revealed no statistical difference with regard to implant survival for the respective groups. The average total cost, per patient, for the DFDB group was 22.5% of the total cost for a patient treated with autogenous bone grafting procedures.
The study concluded that reconstruction of atrophic maxillae with a bone substitute material (DFDB) in combination with GBR can be performed with an equal treatment outcome and with less resources and a significant reduced cost in selected cases compared with autogenous bone grafts from the iliac crest.
自体骨移植和颌骨锚固桥重建萎缩上颌是一种经过充分验证的技术。然而，不应忽视与该概念相关的发病率。此外，包括全身麻醉和住院费用在内，这种治疗的费用非常高。关于各种替代治疗方案的成本效益方法，文献中发现的数据很少。
本回顾性研究旨在从健康经济学和临床角度比较在进行口腔种植治疗前，使用自体髂嵴骨移植或脱矿冻干骨（DFDB）与热塑性载体（美国佛罗里达州阿拉楚阿的 Regeneration Technologies Inc.）联合使用和引导骨再生（GBR）重建萎缩上颌。
共选择了 26 名患者（13 + 13），并根据适应证、性别和年龄进行了匹配。研究在治疗完成后 5 年进行。分析了种植体存活率、发病率和并发症。此外，还对各治疗方式的总费用进行了详细分析，包括材料、人员成本、病假等。
研究结果显示，各分组的种植体存活率无统计学差异。DFDB 组每位患者的平均总费用为自体骨移植组每位患者总费用的 22.5%。
研究表明，在选定的病例中，与自体髂嵴骨移植相比，使用骨替代材料（DFDB）联合 GBR 重建萎缩上颌可以达到同等的治疗效果，并可以使用更少的资源和显著降低成本。
