Herford Alan Scott, Tandon Rahul, Stevens Timothy W, Stoffella Enrico, Cicciu Marco
Department of Oral and Maxillofacial Surgery, Loma Linda University, Loma Linda, California, USA.
J Craniofac Surg. 2013 Jul;24(4):1383-7. doi: 10.1097/SCS.0b013e318292c2ce.
The goal of this study was to demonstrate the technique and effectiveness of incorporating recombinant human bone morphogenetic protein-2 (rhBMP-2) to the established sandwich osteotomy technique. Although the success of the sandwich osteotomy procedure has been well documented, we hope to show that the addition of rhBMP-2 will enhance bone formation.We performed a sandwich osteotomy technique in patients who had been treated initially by grafting with suboptimal results. Only defects involving the anterior maxilla (3 patients) or the anterior mandible (1 patient) were included. There were 4 patients, 2 men and 2 women, with an age range of 19 to 62 years. The causes of the ridge deficiencies ranged from pathology to trauma. The height (distance) of distracted transport bone segment was measured. The amount of relapse was measured 6 months after the surgery.All patients exhibited a significant increase in bone height. The amount distracted was 6.75 mm (range, 5-11 mm). The amount of relapse was 8.5% (range, 0%-18%). Dental implants were placed in the reconstructed ridges in all patients. There were no instances of permanent paresthesia. Two patients had exposure of a portion of the hardware, which healed uneventfully.The sandwich osteotomy technique has proven to be an effective method for augmenting deficient alveolar ridges. The addition of rhBMP-2 may aid in its success rate by promoting osteogenesis at the osteotomy site, especially in multiple-operated patients where other traditional techniques have failed to gain the desired ridge height.
本研究的目的是证明将重组人骨形态发生蛋白-2（rhBMP-2）应用于已确立的三明治式截骨术技术的方法及有效性。尽管三明治式截骨术的成功已有充分记录，但我们希望表明添加rhBMP-2将增强骨形成。我们对最初采用植骨治疗但效果欠佳的患者实施了三明治式截骨术。仅纳入涉及上颌前部（3例患者）或下颌前部（1例患者）的缺损。共有4例患者，2例男性和2例女性，年龄范围为19至62岁。牙槽嵴缺损的原因从病理到创伤不等。测量了牵张运输骨段的高度（距离）。术后6个月测量复发量。所有患者的骨高度均显著增加。牵张的量为6.75毫米（范围为5 - 11毫米）。复发量为8.5%（范围为0% - 18%）。所有患者均在重建的牙槽嵴上植入了牙种植体。没有出现永久性感觉异常的情况。2例患者出现部分硬件外露，愈合情况良好。三明治式截骨术已被证明是一种增加牙槽嵴缺损的有效方法。添加rhBMP-2可能通过促进截骨部位的骨生成来提高其成功率，特别是在多次手术的患者中，其他传统技术未能获得所需的牙槽嵴高度。
