Dottore Alexandre M, Kawakami Paulo Y, Bechara Karen, Rodrigues Jose Augusto, Cassoni Alessandra, Figueiredo Luciene C, Piattelli Adriano, Shibli Jamil Awad
Department of Oral Implantology, Dental Research Division, University of Guarulhos, Guarulhos, SP, Brazil.
Clin Implant Dent Relat Res. 2014 Jun;16(3):330-6. doi: 10.1111/cid.12010. Epub 2012 Nov 13.
This prospective, controlled split-mouth study evaluated the stability of dental implants placed in the augmented mandibular areas with alveolar segmental "sandwich" osteotomies using nonceramic hydroxyapatite (ncHA) or autogenous bone.
This study included 11 bilaterally partially edentulous mandibular patients in a split-mouth design. Alveolar augmentation osteotomies were performed bilaterally with interpositional ncHA graft (test group) or interpositional intraoral autogenous bone graft (control group). After 6 months of healing, four implants (two implants in each side) were placed in each patient. Forty-four implants were inserted and loaded after 6-month healing period. At 1-year follow-up, radiographic, prosthetic, and resonance frequency analysis parameters were assessed. Success criteria included absence of pain, sensitivity, suppuration, and implant mobility; absence of continuous peri-implant radiolucency; and distance between the implant shoulder and the first visible bone contact (DIB) < 2 mm.
After a 1-year loading period, the overall implant survival rate was 95.45%, with two implant losses (one of each group). Among the surviving implants (42 out of 44), two did not fulfill the success criteria; therefore, the implant success was 90.90%. DIB was 0.71 ± 0.70 and 0.84 ± 0.72 mm for ncHA and autogenous bone grafts, respectively (p > .05). Implant stability measurements were similar between the groups during the 12-month follow-up (p > .05).
Within the limits of this study, the implants placed either in sites augmented with ncHA or autogenous bone seem to represent a safe and successful procedure, at least, after 12-month follow-up.
本前瞻性、对照性双侧对照研究评估了使用非陶瓷羟基磷灰石（ncHA）或自体骨通过牙槽骨节段性“三明治”截骨术在增宽的下颌区域植入牙种植体的稳定性。
本研究纳入11例双侧部分牙列缺失的下颌患者，采用双侧对照设计。双侧进行牙槽骨增宽截骨术，分别植入ncHA移植物（试验组）或口内自体骨移植物（对照组）。愈合6个月后，为每位患者植入4枚种植体（每侧2枚）。44枚种植体在愈合6个月后植入并加载。在1年随访时，评估影像学、修复和共振频率分析参数。成功标准包括无疼痛、敏感、化脓和种植体松动；种植体周围无连续的透射区；种植体肩部与首次可见骨接触点之间的距离（DIB）<2mm。
经过1年的加载期，种植体总体存留率为95.45%，有2枚种植体丢失（每组各1枚）。在存留的种植体（44枚中的42枚）中，有2枚未达到成功标准；因此，种植体成功率为90.90%。ncHA组和自体骨移植组的DIB分别为0.71±0.70mm和0.84±0.72mm（p>.05）。在12个月的随访期间，两组间的种植体稳定性测量结果相似（p>.05）。
在本研究的范围内，至少在12个月的随访后，植入ncHA或自体骨增宽部位的种植体似乎是一种安全且成功的手术。
