Krasny K, Kamiński A, Krasny M, Zadurska M, Piekarczyk P, Fiedor P
Medicare Dental Practice, Warsaw, Poland.
Transplant Proc. 2011 Oct;43(8):3142-4. doi: 10.1016/j.transproceed.2011.08.002.
Lack of adequate mass of a patient's own bone is still a clinical problem in dental implantology; it precludes dental embedment. Surgical widening of an atrophied alveolar process with the use of an allogeneic bone granulate to fill the bone defect constitutes a first-line method to prepare for implant-prosthetic treatment. Transplantation of allogeneic material allows reconstruction of optimal height, thickness, and width of the alveolar process facilitating a procedure with a good long-term outcome. The study assessed outcomes following augmentation of atrophied alveolar processes before intraosseous implantation.
Filling bone defects in the maxilla and mandible as an introductory measure for implant-prosthetic treatment was performed in 59 patients (24 females and 35 males of age range 22-65 years). Bone granulate was used for maxillary sinus floor elevation (n=29), augmentation of the postextraction alveoli (n=12), and filling of defects in the outer table of the compact bone formed following inflammatory conditions (n=18). The bone grafts were covered with plasma-rich fibrin (PRF) obtained from the patient's blood to accelerate the formation of synostoses and prevent epithelial penetration between the patients' own bone and the bone graft.
In all of the patients normal union was observed, as confirmed by radiological images as well as intraprocedural assessment. Sufficient height and width as well as thickness of the alveolar process was obtained, which allowed embedment.
Allogeneic bone granulate constitutes a good material to reconstruct maxillary and mandibular alveolar processes in out-patient care.
患者自身骨量不足在牙种植学中仍是一个临床问题;这会妨碍牙齿植入。使用同种异体骨颗粒对萎缩的牙槽突进行手术加宽以填充骨缺损是为种植修复治疗做准备的一线方法。同种异体材料的移植能够重建牙槽突的最佳高度、厚度和宽度,从而使手术获得良好的长期效果。本研究评估了骨内植入前萎缩牙槽突增高术后的效果。
对59例患者(24名女性和35名男性,年龄在22至65岁之间)进行上颌骨和下颌骨骨缺损填充,作为种植修复治疗的初步措施。骨颗粒用于上颌窦底提升(n = 29)、拔牙后牙槽嵴增高(n = 12)以及填充炎症后形成的致密骨外板缺损(n = 18)。骨移植材料上覆盖从患者血液中获取的富血小板纤维蛋白(PRF),以加速骨愈合形成并防止患者自身骨与骨移植材料之间的上皮侵入。
通过影像学图像以及术中评估证实,所有患者均观察到正常愈合。获得了足够的牙槽突高度、宽度和厚度,从而能够进行植入。
同种异体骨颗粒是门诊重建上颌和下颌牙槽突的良好材料。