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颗粒骨与块状骨移植:上颌骨萎缩重建后移植体积的三维变化,2 年放射随访。

Particulate vs. block bone grafts: three-dimensional changes in graft volume after reconstruction of the atrophic maxilla, a 2-year radiographic follow-up.

机构信息

Department of Oral and Maxillofacial Surgery, The Sahlgrenska Academy, University of Gothenburg, Sweden.

出版信息

J Craniomaxillofac Surg. 2012 Dec;40(8):654-9. doi: 10.1016/j.jcms.2011.10.032. Epub 2011 Dec 3.

Abstract

BACKGROUND

Extensive alveolar bone resorption in the maxilla limits the possibility of successful placement and osseointegration of endosseous implants for future prosthetic rehabilitation. Autogenous bone from the iliac crest may be used as lateral onlays in the atrophic maxilla, both as block and particulate bone. To our knowledge, there is no three-dimensional 2-year follow-up study measuring the volumetric reduction of the augmented areas comparing particulate and block bone grafts.

PURPOSE

The aim of this study was to conduct a radiographic 2-year follow-up study, using computed tomographic (CT) images in order to evaluate and compare the extent of bone graft resorption in the frontal maxillae augmented by particulate (test) and block bone (control).

MATERIAL AND METHODS

Eleven patients treated with iliac bone grafts and oral implants in the maxilla were followed with CT examinations directly post grafting and after 2 years.

RESULT

The volumetric changes after 6 months were extensive. Additionally, the changes in particulate bone tended to be larger after 2 years compared to block bone, using this protocol. However, the difference was not statistically significant.

CONCLUSION

The present follow-up study showed that there is radiographically complete integration and embedding of implants installed in grafted bone despite extensive initial graft resorption. There was no significant difference in the amount of volumetric reduction between particulate bone and block bone grafts.

摘要

背景

上颌骨广泛的牙槽骨吸收限制了未来修复体成功植入和骨整合的可能性。髂嵴自体骨可用作萎缩上颌骨的外侧増高材料,既可以是块状骨也可以是颗粒状骨。据我们所知,目前还没有三维 2 年随访研究来测量比较颗粒状和块状骨移植后増高区域的体积减少。

目的

本研究旨在通过 CT 图像进行影像学 2 年随访,以评估和比较颗粒状(实验组)和块状(对照组)骨移植在前额上颌骨増高区的骨吸收程度。

材料和方法

11 名上颌骨接受髂骨移植和口腔种植的患者在移植后即刻和 2 年后进行 CT 检查。

结果

6 个月后的体积变化很大。此外,与块状骨相比,使用该方案,颗粒状骨在 2 年后的变化趋势更大,但差异无统计学意义。

结论

本随访研究表明,尽管存在初始移植骨吸收,但植入物在移植骨中具有影像学上的完全整合和嵌入。颗粒状骨和块状骨移植的体积减少量无显著差异。

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