Schultes Günter, Kärcher Hans, Gerzanic Lucia
Department of Oral and Cranio-Maxillofacial Surgery, Medical University of Graz, Graz, Austria.
J Oral Maxillofac Surg. 2013 Feb;71(2):428-32. doi: 10.1016/j.joms.2012.06.005. Epub 2012 Sep 23.
Our aim was to augment the extremely atrophic mandibular alveolar crest with a pedicled transplant as the best option for a satisfactory preprosthetic outcome.
After computed tomography of the mandible, a model was milled for 6 patients. The iliac crest transplant with its vascular pedicle was harvested and, after preliminary preparation, fixed to the model. The transplant was then placed in the axilla. After 3 months, the graft was removed and fixed to the mandible.
The prefabricated transplant fit exactly in all 6 patients. The length of the pedicle and coverage with the newly developed alveolar mucous membrane were satisfactory. The grafts allowed prosthetic reconstruction with good functional outcomes. No bone loss was observed during 7 years of follow-up. Additionally, indocyanine green angiography showed good perfusion in 4 patients after 6 months.
The results suggest that carefully prefabricated pedicled transplants can augment an atrophied mandibular alveolar crest.
我们的目的是通过带蒂移植来增大极度萎缩的下颌牙槽嵴，这是实现令人满意的修复前效果的最佳选择。
对6例患者的下颌骨进行计算机断层扫描后，制作模型。切取带血管蒂的髂嵴移植骨，初步制备后固定于模型上。然后将移植骨置于腋窝。3个月后，取出移植骨并固定于下颌骨。
预制移植骨在所有6例患者中均完全适配。蒂的长度和新形成的牙槽黏膜覆盖情况令人满意。移植骨可实现功能性良好的修复重建。随访7年期间未观察到骨质流失。此外，吲哚菁绿血管造影显示，6个月后4例患者的灌注良好。
结果表明，精心预制的带蒂移植骨可增大萎缩的下颌牙槽嵴。
