Crespi Roberto, Capparè Paolo, Gherlone Enrico Felice
Department of Dentistry, Vita Salute University, San Raffaele Hospital, Milan, Italy,
Oral Maxillofac Surg. 2014 Mar;18(1):59-64. doi: 10.1007/s10006-013-0389-2. Epub 2013 Jan 18.
The aim of this prospective study was to compare the use of a hand mallet versus an electrical mallet in osteotome-assisted surgery for split-crest procedures.
Partially edentulous patients, with an alveolar ridge width inferior to the optimally desirable implant diameter, were selected for this study. Forty-six split-crest procedures were performed in 46 patients. They were randomly divided in two groups: in the control group, 23 patients, the split crest was performed with osteotomes using a handheld mallet, while in the test group, 23 patients, the split crest was prepared with osteotomes using an electrical mallet. Alveolar ridge width and incision dimensions were measured with a periodontal probe, before and after the split-crest procedure. One hundred eighty-one implants were immediately placed. Follow-up examinations were performed at baseline and 6, 12, and 24 months.
The survival rate, at 2-year follow-up, was 98.31%. Indeed, two implants placed in the maxilla failed to integrate at second-stage surgery. The initial width of the alveolar ridge varied from 2 to 3.5 mm; the average was 2.8 ± 0.7 mm. The final ridge width varied from 5 to 8 mm; the average was 7.2 ± 1.7 mm. The split length varied from 7 to 28 mm; the average was 17.5 ± 7.7 mm. No statistically significant differences (P > 0.05) were found between test and control group in split length and alveolar width values before and after the split-crest procedure.
The use of a magnetic mallet provided some essential clinical advantages during crest splitting and immediate implant placement in comparison with a hand mallet.
本前瞻性研究的目的是比较在骨凿辅助的劈开牙槽嵴手术中使用手动骨锤与电动骨锤的情况。
选择牙槽嵴宽度小于最佳种植体直径的部分缺牙患者进行本研究。对46例患者进行了46次劈开牙槽嵴手术。他们被随机分为两组:对照组23例患者,使用手持骨锤通过骨凿进行劈开牙槽嵴手术;试验组23例患者,使用电动骨锤通过骨凿进行劈开牙槽嵴手术。在劈开牙槽嵴手术前后,用牙周探针测量牙槽嵴宽度和切口尺寸。立即植入181颗种植体。在基线以及6个月、12个月和24个月时进行随访检查。
在2年随访时,种植体存活率为98.31%。事实上,上颌植入的两颗种植体在二期手术时未能成功整合。牙槽嵴初始宽度为2至3.5毫米;平均为2.8±0.7毫米。最终牙槽嵴宽度为5至8毫米;平均为7.2±1.7毫米。劈开长度为7至28毫米;平均为17.5±7.7毫米。在劈开牙槽嵴手术前后,试验组和对照组在劈开长度和牙槽嵴宽度值方面未发现统计学上的显著差异(P>0.05)。
与手动骨锤相比,在劈开牙槽嵴和即刻种植体植入过程中,使用电动骨锤具有一些重要的临床优势。