Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, 4 Klachkin Street, Tel Aviv, Israel.
J Biomed Mater Res A. 2011 Jun 15;97(4):509-13. doi: 10.1002/jbm.a.33096. Epub 2011 Apr 20.
The present study was conducted to histologically and histomorphometrically evaluate the application of cancellous bone-block allografts for the augmentation of the posterior atrophic mandible. Twenty-four consecutive patients underwent augmentation with cancellous bone-block allografts in the posterior mandible. A bony deficiency of at least 3 mm horizontally and/or vertically according to CT para-axial reconstruction served as inclusion criteria. Following 6 months, 85 implants were placed and a cylindrical sample core was collected. All specimens were prepared for histological and histomorphometrical examination. Implant survival rate was 95.3%. Follow-up ranged 12-66 months (mean 43 ± 19 months). The mean newly formed bone was 44 ± 28%, that of the residual cancellous bone-block allograft 29 ± 24%, and of the marrow and connective tissue 27 ± 21%. Statistically significant histomorphometric differences regarding newly formed bone (69% vs. 31%, p = 0.05) were found between younger (< 45 years) and older (> 45 years) patients, respectively. Histomorphometric differences regarding residual cancellous bone-block allograft (17% vs. 35%) and of the marrow and connective tissue (14% vs. 34%) were not statistically significant. Cancellous bone-block allograft is biocompatible and osteoconductive, permitting new bone formation following augmentation of extremely atrophic posterior mandible with a two-stage implant placement procedure. New bone formation was age-dependent.
本研究旨在通过组织学和组织形态计量学评估松质骨块同种异体移植物在后萎缩性下颌骨增强中的应用。24 例连续患者在后下颌骨接受松质骨块同种异体移植物增强。根据 CT 轴旁重建,水平和/或垂直至少有 3 毫米的骨缺损作为纳入标准。6 个月后,共放置了 85 个种植体,并收集了一个圆柱形样本芯。所有标本均进行了组织学和组织形态计量学检查。种植体存活率为 95.3%。随访时间为 12-66 个月(平均 43 ± 19 个月)。新形成的骨平均为 44 ± 28%,残留的松质骨块同种异体移植物为 29 ± 24%,骨髓和结缔组织为 27 ± 21%。在年轻(<45 岁)和老年(>45 岁)患者之间,新形成的骨(69%对 31%,p = 0.05)存在统计学上显著的组织形态计量学差异。残留的松质骨块同种异体移植物(17%对 35%)和骨髓和结缔组织(14%对 34%)之间的组织形态计量学差异无统计学意义。松质骨块同种异体移植物具有生物相容性和骨诱导性,允许在采用两阶段种植体植入程序对极度萎缩的后下颌骨进行增强后形成新骨。新骨形成与年龄有关。