Department of Oral and Maxillofacial Surgery, Science of Physical Function, Division of Oral and Maxillofacial Reconstructive Surgery, Kyushu Dental College, Fukuoka, Japan.
Clin Implant Dent Relat Res. 2012 Apr;14(2):304-11. doi: 10.1111/j.1708-8208.2009.00257.x. Epub 2011 Mar 31.
The purpose of this study was to evaluate the quality and quantity of augmented bone following alveolar ridge reconstruction with titanium mesh and autogenous particulate bone graft for implant placement in terms of the preoperative bone defect.
Forty-one patients (50 sites) rehabilitated between September 2000 and May 2009 with autogenous particulate intraoral bone or iliac cancellous bone marrow grafts and micro-titanium meshes were enrolled. We classified the bone defects by means of shape as complex horizontal-vertical (HV), horizontal (H), and socket (S) types, and the augmented bone was evaluated based on preoperative computed tomographic data. The postsurgical complications were assessed during the healing period and after implant superstructure placement.
The bone defects were successfully augmented using the titanium mesh technique. The HV-type defect was the most difficult to augment (mean horizontal gain, 3.7 ± 2.0 [SD] mm; mean vertical gain, 5.4 ± 3.4 [SD] mm). The mean horizontal gain with the H-type defect was 3.9 ± 1.9 mm. The S-type defect achieved the most efficient bone augmentation (mean horizontal gain, 5.7 ± 1.4 [SD] mm; mean vertical gain, 12.4 ± 3.1 [SD] mm). The major postsurgical complications were mesh exposure, infection, total or partial bone resorption, and temporary neurological disturbances. Implant failure was observed in one case. The HV-type defect showed significantly higher bone resorption (p < .05) than the other defect types.
Autogenous bone grafting with titanium mesh allows adequate vertical and horizontal alveolar bone reconstruction both quantitatively and qualitatively for implant placement. However, the clinical outcome of augmentation depends on the type of preoperative bone defect.
本研究旨在评估钛网和自体颗粒骨移植用于牙槽嵴重建后植入物放置的骨量和质量，根据术前骨缺损的情况。
2000 年 9 月至 2009 年 5 月期间，我们对 41 名患者（50 个部位）采用自体颗粒骨或髂骨松质骨髓移植联合微钛网进行了治疗。我们通过形状将骨缺损分为复杂的水平-垂直型（HV）、水平型（H）和牙槽窝型（S），并根据术前 CT 数据评估增强骨。在愈合期和种植体上部结构放置后评估术后并发症。
采用钛网技术成功地增强了骨缺损。HV 型缺损最难增强（平均水平增加 3.7 ± 2.0 [SD] mm；平均垂直增加 5.4 ± 3.4 [SD] mm）。H 型缺损的平均水平增加为 3.9 ± 1.9 mm。S 型缺损实现了最有效的骨增强（平均水平增加 5.7 ± 1.4 [SD] mm；平均垂直增加 12.4 ± 3.1 [SD] mm）。主要的术后并发症是网暴露、感染、全部或部分骨吸收和暂时的神经功能障碍。一例发生种植体失败。HV 型缺损的骨吸收明显高于其他缺损类型（p <.05）。
自体骨移植联合钛网可实现定量和定性的垂直和水平牙槽骨重建，以进行植入物放置。然而，增强的临床效果取决于术前骨缺损的类型。
