Mandelaris George A, Spagnoli Daniel B, Rosenfeld Alan L, McKee James, Lu Mei
Int J Periodontics Restorative Dent. 2015 May-Jun;35(3):325-33. doi: 10.11607/prd.2378.
This case report describes a tissue-engineered reconstruction with recombinant human bone morphogenetic protein 2/acellular collagen sponge (rhBMP-2/ ACS) + cancellous allograft and space maintenance via Medpor Contain mesh in the treatment of a patient requiring maxillary and mandibular horizontal ridge augmentation to enable implant placement. The patient underwent a previously unsuccessful corticocancellous bone graft at these sites. Multiple and contiguous sites in the maxilla and in the mandibular anterior, demonstrating advanced lateral ridge deficiencies, were managed using a tissue engineering approach as an alternative to autogenous bone harvesting. Four maxillary and three mandibular implants were placed 9 and 10 months, respectively, after tissue engineering reconstruction, and all were functioning successfully after 24 months of follow-up. Histomorphometric analysis of a bone core obtained at the time of the maxillary implant placement demonstrated a mean of 76.1% new vital bone formation, 22.2% marrow/cells, and 1.7% residual graft tissue. Tissue engineering for lateral ridge augmentation with combination therapy requires further research to determine predictability and limitations.
本病例报告描述了使用重组人骨形态发生蛋白2/脱细胞胶原海绵(rhBMP-2/ACS)+松质骨同种异体移植物进行组织工程重建,并通过Medpor Contain网片维持间隙,以治疗一名需要上颌和下颌水平牙槽嵴增高以植入种植体的患者。该患者此前在这些部位进行的皮质松质骨移植未成功。上颌和下颌前部多个连续部位存在严重的侧方牙槽嵴缺损,采用组织工程方法替代自体骨采集进行处理。组织工程重建后分别于9个月和10个月植入4枚上颌种植体和3枚下颌种植体,随访24个月时所有种植体均功能良好。对上颌种植体植入时获取的骨芯进行组织形态计量学分析显示,新生活性骨形成平均占76.1%,骨髓/细胞占22.2%,残余移植组织占1.7%。联合治疗进行侧方牙槽嵴增高的组织工程需要进一步研究以确定其可预测性和局限性。