Department of Periodontology, UNESP - University Estadual Paulista, Araraquara Dental School, Araraquara, São Paulo, Brazil; Department of Dentistry - Oral Radiology, Aarhus University, Aarhus, Denmark; Department of Dentistry - Periodontology, School of Dentistry, Aarhus University, Aarhus, Denmark.
Clin Oral Implants Res. 2014 Feb;25(2):226-33. doi: 10.1111/clr.12107. Epub 2013 Jan 25.
To compare autogenous bone (AT) and fresh-frozen allogeneic bone (AL) in terms of histomorphometrical graft incorporation and implant osseointegration after grafting for lateral ridge augmentation in humans.
Thirty-four patients were treated with either AL (20 patients) or AT (14 patients) onlay grafts. During implant installation surgery 6 months after grafting, cylindrical biopsies were harvested perpendicularly to the lateral aspect of the augmented alveolar ridge. Additionally, titanium mini-implants were installed in the grafted regions, also perpendicularly to the ridge; these were biopsied during second-stage surgery. Histological/histomorphometric analysis was performed using decalcified and non-decalcified sections.
Histological analysis revealed areas of necrotic bone (NcB) occasionally in contact with or completely engulfed by newly formed vital bone (VB) in both AT and AL groups (55.9 ± 27.6 vs. 43.1 ± 20.3, respectively; P = 0.19). Statistically significant larger amounts of VB (27.6 ± 17.5 vs. 8.4 ± 4.9, respectively; P = 0.0002) and less soft connective tissue (ST) (16.4 ± 15.6 vs. 48.4 ± 18.1, respectively; P ≤ 0.0001) were seen for AT compared with AL. No significant differences were observed between the groups regarding both bone-to-implant contact (BIC) and the bone area between implant threads (BA) on the mini-implant biopsies.
Allogeneic bone block grafts may be an option in cases where a limited amount of augmentation is needed, and the future implant can be expected confined within the inner aspect of the bone block. However, the clinical impact of the relatively poor graft incorporation on the long-term performance of oral implants placed in AL grafts remains obscure.
比较自体骨（AT）和新鲜冷冻同种异体骨（AL）在人类外侧嵴增高中移植后组织形态计量学移植物整合和种植体骨整合的情况。
34 名患者接受了 AL（20 名患者）或 AT（14 名患者）的覆盖移植。在移植后 6 个月的种植体安装手术期间，从增强牙槽嵴的外侧垂直采集圆柱形活检。此外，还在移植区域垂直于嵴部植入钛迷你种植体；这些在二期手术中进行活检。使用脱钙和非脱钙切片进行组织学/组织形态计量学分析。
组织学分析显示，AT 和 AL 组中偶尔会出现坏死骨（NcB）区域，这些区域与新形成的活骨（VB）接触或完全被 VB 吞噬（分别为 55.9 ± 27.6%和 43.1 ± 20.3%；P = 0.19）。AT 组的 VB 量明显更大（27.6 ± 17.5%比 8.4 ± 4.9%；P = 0.0002），而 ST 更少（16.4 ± 15.6%比 48.4 ± 18.1%；P ≤ 0.0001）。两组之间在迷你种植体活检上的骨-种植体接触（BIC）和种植体螺纹间骨面积（BA）方面无显著差异。
同种异体骨块移植可能是一种选择，适用于需要有限量增加的情况，并且可以预期未来的种植体局限于骨块的内侧。然而，在 AL 移植中放置的口腔种植体的长期性能方面，相对较差的移植物整合对其临床影响尚不清楚。
