Nissan Joseph, Gross Ora, Mardinger Ofer, Ghelfan Oded, Sacco Roberto, Chaushu Gavriel
Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
J Oral Maxillofac Surg. 2011 Dec;69(12):e513-8. doi: 10.1016/j.joms.2011.08.002. Epub 2011 Oct 8.
To prospectively evaluate the outcome of dental implants placed in the post-traumatic anterior maxilla after ridge augmentation with cancellous freeze-dried block bone allografts.
Patients presenting with a history of anterior dentoalveolar trauma with bony deficiencies in the sagittal (≥3 mm) and vertical (<3 mm) planes according to computed tomography were included. The recipient sites were reconstructed with cancellous bone block allografts. After 6 months of healing, implants were placed. The primary outcomes of interest were 1) bone measurements taken before grafting, at the time of implant placement, and at stage 2 operations; 2) implant survival; and 3) complications.
The sample was composed of 20 consecutive patients with a mean age of 25 ± 7 years. We used 28 cancellous allogeneic bone blocks, and 31 implants were inserted. Of the 31 implants, 12 were immediately restored. The mean follow-up was 42 ± 15 months. Graft and implant survival rates were 92.8% and 96.8%, respectively. Mean bone gain in the sagittal and vertical planes was 5 ± 0.5 mm horizontally and 2 ± 0.5 mm (P < .001). Successful restoration was achieved in all patients with fixed implant-supported prostheses. Soft tissue complications occurred in 7 patients (35%). Complications after cementation of the crowns were seen in 3 implants (9.6%). All implants remained clinically osseointegrated at the end of the follow-up examination. There was no crestal bone loss around the implants beyond the first implant thread.
Cancellous block allograft can be used successfully for post-traumatic implant-supported restoration in the anterior maxilla.
前瞻性评估在使用松质冻干块状同种异体骨进行牙槽嵴增高后，植入创伤后上颌前部的牙种植体的效果。
纳入根据计算机断层扫描显示存在矢状面（≥3 mm）和垂直面（<3 mm）骨缺损的前牙牙槽创伤史患者。受体部位用松质骨块状同种异体骨进行重建。愈合6个月后植入种植体。主要关注的结果为：1）在植骨前、种植体植入时和二期手术时进行的骨测量；2）种植体存活率；3）并发症。
样本包括20例连续患者，平均年龄25±7岁。我们使用了28块松质同种异体骨块，植入了31颗种植体。在31颗种植体中，12颗立即进行了修复。平均随访时间为42±15个月。植骨和种植体存活率分别为92.8%和96.8%。矢状面和垂直面的平均骨增量水平为5±0.5 mm，垂直为2±0.5 mm（P<.001）。所有采用种植体支持固定修复的患者均成功完成修复。7例患者（35%）出现软组织并发症。3颗种植体（9.6%）出现冠修复后并发症。在随访检查结束时，所有种植体在临床上均保持骨结合。种植体周围在第一种植体螺纹以外没有牙槽骨吸收。
松质块状同种异体骨可成功用于创伤后上颌前部种植体支持的修复。
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