Santagata Mario, Guariniello Luigi, Tartaro Gianpaolo
Department of Head and Neck Pathologies, Oral Cavity and Audio-Verbal Communication, University Hospital (AOU) - Second University of Naples, Naples, Italy.
J Oral Implantol. 2015 Apr;41(2):184-7. doi: 10.1563/AAID-JOI-D-12-00308. Epub 2013 May 3.
Restoration of the edentulous alveolar ridge with implants often requires the ridge width to be augmented to allow its placement. The aim of this study was to evaluate the split-crest technique, with subepithelial connective tissue graft used as biological barrier, in patients with narrow ridges, focusing on the status of soft and hard tissues and on implant success rate, at 36 months after implant loading. Thirteen patients (6 males and 7 females), ages 32-68 years (mean 49.4 years) with an atrophic maxillary jaw underwent modified edentulous ridge expansion technique for implant placement. A total of 33 Laser-Lok tapered internal implant, were placed in the maxilla. The following parameters were evaluated: (1) initial ridge width (time t0); (2) ridge width at the time of abutment connection (time t1); four months after implants placement, healing abutments were connected and the prosthetic rehabilitation was initiated, and all patients were evaluated clinically and radiographically with periapical radiograph at intervals of 3-6 months for the first year and annually thereafter for 3 years. The ridge width was measured with a cone beam computed tomography. The initial ridge width ranged from 3.5 mm to 7 mm (mean: 4.67 mm), while at the end of the expansion procedure the width ranged from 6.3 mm to 11.0 mm (mean: 8.2 mm). The width gain of the edentulous ridge ranged from 1.45-4.9 mm (mean: 3.5 mm). Two implants became exposed 1 month after surgery. One implant was lost before loading (3%). The diameter of failed implant was 5.8 mm and length was 10.5 mm. The remaining 32 implants were stable and free of complications at the end of the study. Thus, the implant survival rate was 97%. Because no implant failed after loading, the cumulative survival rate of loaded implants was 100%. The minimally invasive regenerative technique presented here avoids the use of bone graft, secondary surgery for soft tissue augmentation, and mechanical expansion devices. However, the follow-up period for outcome evaluation and exiguous patient's number in this series was limited.
使用种植体修复无牙牙槽嵴通常需要增加牙槽嵴宽度以利于种植体植入。本研究旨在评估在窄牙槽嵴患者中采用以龈下结缔组织移植作为生物屏障的劈嵴技术，重点关注种植体加载后36个月时软硬组织的状况及种植体成功率。13例患者（6例男性和7例女性），年龄32 - 68岁（平均49.4岁），上颌骨萎缩，接受了改良的无牙嵴扩展技术以植入种植体。共在上颌植入33枚Laser - Lok锥形内部种植体。评估了以下参数：(1)初始牙槽嵴宽度（时间t0）；(2)基台连接时的牙槽嵴宽度（时间t1）；种植体植入4个月后，连接愈合基台并开始进行修复康复，所有患者在第一年每隔3 - 6个月进行临床和根尖片影像学评估，此后每年评估3年。使用锥形束计算机断层扫描测量牙槽嵴宽度。初始牙槽嵴宽度为3.5毫米至7毫米（平均：4.67毫米），而在扩展程序结束时宽度为6.3毫米至11.0毫米（平均：8.2毫米）。无牙牙槽嵴的宽度增加范围为1.45 - 4.9毫米（平均：3.5毫米）。术后1个月有2枚种植体暴露。1枚种植体在加载前丢失（3%）。失败种植体的直径为5.8毫米，长度为10.5毫米。研究结束时，其余32枚种植体稳定且无并发症。因此，种植体存活率为97%。由于加载后无种植体失败，加载种植体的累积存活率为100%。此处介绍的微创再生技术避免了使用骨移植、软组织增量的二次手术以及机械扩展装置。然而，本系列中用于结果评估的随访期有限且患者数量较少。
