Vidyadharan Arun Kumar, Ravindran Anjana
Department of Endodontics and Implant Dentistry, S.U.T.A.M.S Medical College, Trivandrum, India.
Indian J Dent Res. 2014 Jul-Aug;25(4):445-8. doi: 10.4103/0970-9290.142524.
Patient wanted to restore her lost teeth with implants in the lower left first molar and second premolar region. Cone beam computerized tomography (CBCT) revealed inadequate bone width and height around future implant sites. The extraction socket of second premolar area revealed inadequate socket healing with sparse bone fill after 4 months of extraction.
To evaluate the clinical feasibility of using a collagen physical resorbable barrier made of human pericardium (HP) to augment localized alveolar ridge defects for the subsequent placement of dental implants.
Ridge augmentation was done in the compromised area using Puros® demineralized bone matrix (DBM) Putty with chips and an HP allograft membrane. Horizontal (width) and vertical hard tissue measurements with CBCT were recorded on the day of ridge augmentation surgery, 4 month and 7 months follow-up. Intra oral periapical taken 1 year after implant installation showed minimal crestal bone loss.
Bone volume achieved through guided bone regeneration was a gain of 4.8 mm horizontally (width) and 6.8 mm vertically in the deficient ridge within a period of 7 months following the procedure.
The results suggested that HP Allograft membrane may be a suitable component for augmentation of localized alveolar ridge defects in conjunction with DBM with bone chips.
患者希望通过在下颌左侧第一磨牙和第二前磨牙区域植入种植体来修复缺失牙。锥形束计算机断层扫描(CBCT)显示未来种植部位周围的骨宽度和高度不足。第二前磨牙区域的拔牙窝在拔牙4个月后显示愈合不佳,骨填充稀疏。
评估使用由人心包(HP)制成的可物理吸收的胶原屏障来增加局部牙槽嵴缺损以用于后续种植体植入的临床可行性。
在受损区域使用含有碎骨片的Puros®脱矿骨基质(DBM)糊剂和HP同种异体移植膜进行牙槽嵴增高术。在牙槽嵴增高手术当天、4个月和7个月随访时,用CBCT记录水平(宽度)和垂直硬组织测量值。种植体植入1年后拍摄的口腔内根尖片显示牙槽嵴顶骨吸收极少。
通过引导骨再生在术后7个月内,缺损牙槽嵴水平(宽度)增加了4.8毫米,垂直增加了6.8毫米。
结果表明,HP同种异体移植膜可能是与含骨碎片的DBM联合用于增加局部牙槽嵴缺损的合适材料。