Kim Young-Kyun, Lee Junho, Yun Ji-Young, Yun Pil-Young, Um In-Woong
Department of Oral & Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Oral & Maxillofacial Surgery, Seoul National University School of Dentistry, Seoul, Korea.
Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea.
J Periodontal Implant Sci. 2014 Oct;44(5):216-21. doi: 10.5051/jpis.2014.44.5.216. Epub 2014 Oct 29.
This retrospective study compares the amount of bone resorption around implants between an autogenous tooth bone graft (AutoBT) and a synthetic bone graft after a bone-added crestally approached sinus lift with simultaneous implant placements.
In all, 37 patients participated in this study. Seventeen patients were grouped as group I and underwent an AutoBT-added sinus lift using the crestal approach. The remaining 20 patients were grouped as group II and underwent synthetic bone grafting. Both groups received the implant placements simultaneously. Of the 37 participating patients, only 22 patients were included in the final results: Eleven patients of group I and 11 patients of group II. Before the surgery, the distance from the alveolar crest to the sinus floor was measured using panoramic radiography. After the surgery, the distance was measured again from the neck of the implant thread to the most superior border of the added graft materials. Then, the amount of sinus lift was calculated by comparing the two panoramic radiographs. After a year, a panoramic radiograph was taken to calculate the resorption of the bone graft material from the radiograph that was taken after the surgery. The significance of the resorption amount between the two types of graft materials was statistically analyzed.
The bone height was increased to an average of 4.89 mm in group I and 6.22 mm in group II. The analysis of panoramic radiographs 1 year after the surgery showed an average bone resorption of 0.76 mm and 0.53 mm, respectively. However, the degree of lifting (P=0.460) and the amount of bone-grafted material resorption (P=0.570) showed no statistically significant difference.
Based on this limited study, AutoBT can be considered a good alternative bone graft to a synthetic bone graft in a bone-added sinus lift, when extraction is necessary prior to the surgery.
本回顾性研究比较了自体牙骨移植(AutoBT)和人工骨移植在经牙槽嵴顶入路的上颌窦提升同期种植术中种植体周围骨吸收的情况。
共有37例患者参与本研究。17例患者被分为I组,采用经牙槽嵴顶入路进行自体牙骨移植上颌窦提升术。其余20例患者被分为II组,接受人工骨移植。两组均同期进行种植体植入。在37例参与研究的患者中,最终结果仅纳入22例患者:I组11例患者和II组11例患者。术前,使用全景X线片测量牙槽嵴顶至窦底的距离。术后,再次测量从种植体螺纹颈部至添加的移植材料最上缘的距离。然后,通过比较两张全景X线片计算上颌窦提升的量。术后一年,拍摄全景X线片以计算术后拍摄的X线片中骨移植材料的吸收情况。对两种移植材料吸收量的差异进行统计学分析。
I组骨高度平均增加至4.89mm,II组为6.22mm。术后1年的全景X线片分析显示,平均骨吸收分别为0.76mm和0.53mm。然而,提升程度(P = 0.460)和骨移植材料吸收量(P = 0.570)均无统计学显著差异。
基于这项有限的研究,在术前需要拔牙的上颌窦提升术中,自体牙骨移植可被视为人工骨移植的良好替代骨移植材料。