Diez G F, Fontão F N G K, Bassi A P F, Gama J C, Claudino M
Department of Oral Surgery, University of Planalto Catarinense (UNIPLAC), Lages, Santa Catarina, Brazil.
Postgraduate Department, Latin American Institute of Dental Research and Education (ILAPEO), Curitiba, Paraná, Brazil.
Int J Oral Maxillofac Surg. 2014 Mar;43(3):335-40. doi: 10.1016/j.ijom.2013.08.010. Epub 2013 Sep 23.
Autogenous bone is still considered the gold standard, and the applicability of autogenous bone grafts is well established. However, the possibility of second harvesting from the same donor region remains unclear. The aim of this study was to perform a prospective evaluation of hard tissue deposition in the mandibular ramus after bone block harvesting using cone beam computed tomography (CBCT). Twenty-two patients with indications for augmentation procedures using autogenous bone from the mandibular ramus were selected. Three CBCT scans were performed with a tomographic guide before bone harvesting (T1) and at 14 days (T2) and 6 months (T3) after the surgical procedures. Measurements were obtained in 2D (area, mm(2)) and 3D (volume, mm(3)), and were subsequently compared. In the 2D analysis, the mean bone formation rate was 56%, while for the 3D analysis the mean rate was 9.7%. Despite this difference, there was a significant correlation between area and volume measurements. Our findings demonstrated the presence of hard tissue in the mandibular ramus at 6 months after bone harvesting, which suggests that it would be possible to reuse the same region for a second block harvesting. However, the second bone harvesting would involve less bone for transplantation when compared to the first bone harvesting.
自体骨仍被视为金标准，并且自体骨移植的适用性已得到充分证实。然而，从同一供体区域进行二次取材的可能性仍不明确。本研究的目的是使用锥形束计算机断层扫描（CBCT）对下颌升支骨块取材后硬组织沉积进行前瞻性评估。选择了22例有指征使用下颌升支自体骨进行增量手术的患者。在骨取材前（T1）以及手术操作后14天（T2）和6个月（T3）使用断层扫描导向进行了三次CBCT扫描。在二维（面积，mm²）和三维（体积，mm³）上进行测量，随后进行比较。在二维分析中，平均骨形成率为56%，而在三维分析中平均率为9.7%。尽管存在这种差异，但面积和体积测量之间存在显著相关性。我们的研究结果表明，在骨取材后6个月下颌升支存在硬组织，这表明有可能在同一区域再次取材获取骨块。然而，与首次骨取材相比，第二次骨取材可用于移植的骨量会减少。
