Department of Oral Rehabilitation, Tel Aviv University, Israel.
Int J Oral Maxillofac Implants. 2012 Jan-Feb;27(1):84-9.
Grafting with bone blocks may be required to restore the alveolar process in extremely atrophic maxillae prior to implant placement to ensure both function and esthetics. The present study was conducted to histologically and histomorphometrically evaluate the application of allograft cancellous bone blocks for the augmentation of the anterior atrophic maxilla.
Consecutive patients with severe atrophy in the anterior maxilla underwent augmentation with cancellous bone block allografts. Bony deficiencies of at least 3 mm horizontally and up to 3 mm vertically according to computed tomographic para-axial reconstructions served as inclusion criteria. After 6 months, implants were placed and a cylindric sample core from the graft area was collected. All specimens were prepared for histologic and histomorphometric examination.
Forty patients were included in the study. Eighty-three implants were placed in bone that was augmented with 60 cancellous freeze-dried bone block allografts. The implant survival rate was 98.8%. Mean follow-up was 48 ± 22 months (range, 14 to 82 months). The mean percentage of newly formed bone was 33% ± 18%, that of the residual cancellous block allograft was 26% ± 17%, and marrow and connective tissue comprised 41% ± 2%. Statistically significant histomorphometric differences regarding newly formed bone and residual cancellous block allograft were found between younger (< 40 years) and older (≥ 40 years) patients, respectively. Age did not appear to influence the percentage of marrow and connective tissue.
Cancellous bone block allograft is biocompatible and osteoconductive, permitting new bone formation following augmentation of extremely atrophic anterior maxillae in a two-stage implant placement procedure. New bone formation was age-dependent.
在种植体植入前，为了恢复极度萎缩的上颌牙槽突，可能需要进行骨块移植，以确保功能和美观。本研究旨在通过组织学和组织形态计量学评估同种异体松质骨块在增加前萎缩上颌骨中的应用。
连续的严重上颌前萎缩患者接受同种异体松质骨块移植进行增强。根据 CT 轴位重建，至少有 3mm 水平和 3mm 垂直的骨缺损被纳入标准。6 个月后，植入物被放置，从移植物区域收集一个圆柱形样本芯。所有标本均进行组织学和组织形态计量学检查。
共有 40 名患者入组研究。60 个同种异体冻干松质骨块被用于增强 83 个植入物的植入部位。种植体存活率为 98.8%。平均随访时间为 48±22 个月（范围 14 至 82 个月）。新骨形成的平均百分比为 33%±18%，残留的松质骨块移植物的平均百分比为 26%±17%，骨髓和结缔组织占 41%±2%。新骨形成和残留的松质骨块移植物的组织形态计量学差异在年龄小于 40 岁（<40 岁）和大于或等于 40 岁（≥40 岁）的患者之间有统计学意义。年龄似乎不影响骨髓和结缔组织的百分比。
松质骨块移植物具有生物相容性和骨诱导性，可在两阶段种植体植入过程中增加极度萎缩的前上颌骨，从而促进新骨形成。新骨形成与年龄有关。
