Chiapasco Matteo, Di Martino Giuseppe, Anello Tommaso, Zaniboni Marco, Romeo Eugenio
Unit of Oral Surgery, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy.
Clin Implant Dent Relat Res. 2015 Jan;17 Suppl 1:e251-66. doi: 10.1111/cid.12191. Epub 2013 Dec 27.
The purpose of this study was to compare (1) the clinical outcome of the reconstruction of extremely atrophic edentulous maxillae with fresh frozen allogeneic bone (FFB) (group A) and autogenous bone (AB) (group B) iliac blocks; and (2) the peri-implant bone resorption and the survival rate of implants in the two groups.
In a 1-year period, eight patients were treated with FFB and seven with AB iliac grafts. Five to seven months afterward, 108 implants were inserted (59 in group A and 49 in group B). Four to five months afterward, patients were rehabilitated with implant-supported prostheses. The mean follow-up was 24 months.
Prior to implant placement, graft exposure occurred in two patients in group A and in one patient in group B. The mean graft resorption prior to implant placement was 0.78 mm and 0.54 mm in group A and B, respectively. After implant placement, bone graft exposures with partial loss of the graft occurred in six out of eight patients in group A and in none of the group B patients. The survival rate of implants was 90.1% and 100% in group A and B, respectively. The mean values of peri-implant bone resorption at the end of the follow-up period were 1.64 mm and 0.92 mm in group A and B, respectively.
Results of this study seem to demonstrate that FFB does not represent a reliable alternative to AB blocks because of the higher rate of bone exposure and partial loss of the grafts, the lower implant survival, and the higher peri-implant bone resorption in FFB patients.
本研究的目的是比较:(1)使用新鲜冷冻同种异体骨(FFB)(A组)和自体骨(AB)髂骨块重建极度萎缩无牙上颌骨的临床结果;以及(2)两组中种植体周围骨吸收情况和种植体存活率。
在1年时间里,8例患者接受了FFB治疗,7例患者接受了AB髂骨移植。5至7个月后,植入了108颗种植体(A组59颗,B组49颗)。4至5个月后,患者使用种植体支持的假体进行修复。平均随访时间为24个月。
在种植体植入前,A组有2例患者发生植骨暴露,B组有1例患者发生植骨暴露。种植体植入前A组和B组植骨的平均吸收量分别为0.78毫米和0.54毫米。种植体植入后,A组8例患者中有6例发生植骨暴露并伴有部分植骨丢失,B组患者均未出现这种情况。A组和B组种植体的存活率分别为90.1%和100%。随访期末,A组和B组种植体周围骨吸收的平均值分别为1.64毫米和0.92毫米。
本研究结果似乎表明,由于FFB患者骨暴露和植骨部分丢失的发生率较高、种植体存活率较低以及种植体周围骨吸收较高,FFB不能作为AB骨块的可靠替代物。