Dental School, University of Chieti-Pescara, Italy.
Int J Immunopathol Pharmacol. 2011 Apr-Jun;24(2 Suppl):71-5. doi: 10.1177/03946320110240S213.
The purpose of this paper was to document the application to the split-crest mandibular procedure in two stage in order to avoid cortical resorption due to periosteal detachment in buccal cortical bone of the alveolar crest. Twenty-two healthy patients with non-contributory past medical history (14 women and 8 men, all non-smokers, mean age 59 years, range 54-65 years) were included in this study. After buccal mucoperiosteal flap was followed by a sagittal corticotomy in the coronal area of the alveolar crest and a second sagittal corticotomy, but in a lower (basal) position and two vertical corticotomies in the buccal wall, using a ultrasonic surgery device (Surgysonic, Esacrom, Imola Italy). Adequate crest expansion was achieved without compromising cortical vascularisation by utilising a combination of scalpel, thin chisels and threaded osteotomes (Bone System, Milano, Italy). Postoperative results were assessed by panoramic and periapical radiographs. Ossification of the osteotomy lines was evident and could be observed as sites with increasing radiopacity on panoramic and periapical radiographs 3 months after implants insertion. No dehiscence of the mucosa was observed. No patient suffered from hypoaesthesia. The mean horizontal bone increase in coronal area was 5±3 mm. Mandibular ridge expansion using a split-crest technique that included grafting the implant sites with a ultrasonic surgery device is a viable therapeutic alternative for implant placement in this patient population.
本文旨在记录在两阶段分体式下颌骨程序中的应用，以避免由于颊侧皮质骨的骨膜剥离导致牙槽嵴皮质吸收。本研究纳入了 22 名无明显既往病史的健康患者（14 名女性和 8 名男性，均不吸烟，平均年龄 59 岁，范围 54-65 岁）。在颊侧黏膜骨膜瓣游离后，在牙槽嵴的冠状区域进行矢状骨切开术和第二次矢状骨切开术，但位置更低（基底），并在颊侧壁进行两次垂直骨切开术，使用超声手术设备（Surgysonic，Esacrom，Imola Italy）。通过结合使用手术刀、薄凿子和螺纹骨凿（Bone System，Milano，Italy），在不影响皮质血管化的情况下实现了足够的牙槽嵴扩展。术后结果通过全景和根尖片评估。骨切开线的骨化明显，在植入物插入后 3 个月，在全景和根尖片上可以观察到骨密度增加的部位。黏膜无裂开。无患者出现感觉减退。冠状区的平均水平骨增加为 5±3mm。使用分体式技术（包括使用超声手术设备在种植体部位进行植骨）进行下颌骨嵴扩展，是该患者群体中植入物放置的一种可行的治疗选择。
