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[牙齿修复前牙槽骨缺损的牵张成骨术]

[Distraction osteogenesis of deficient alveolar bone prior to dental rehabilitation].

作者信息

Shilo D, Emodi O, Aizenbud D, Rachmiel A

出版信息

Refuat Hapeh Vehashinayim (1993). 2015 Jul;32(3):38-42, 69.

Abstract

Implant supported rehabilitation has become very common in treatment plans nowadays, yet many patients lack the vertical and horizontal bone dimensions required for endosseous implant insertion. Distraction osteogenesis is a technique in which bone is generated by progressive elongation of two bone fragments following an osteotomy or corticotomy. Distraction osteogenesis of the alveolar ridge as a treatment modality in implant dentistry is a very useful technique that allows for adequate bone formation suitable for implant insertion. Alveolar distraction can be unidirectional, bidirectional, multidirectional or horizontal. Alveolar distraction osteogenesis can be performed by using intraosseous distraction devices, intraosseous distraction implants or by extraosseous devices which are the most prevalent today. Distraction osteogenesis has many advantages such as gradual lengthening of the bone with no need for an autogenous bone graft and lack of the associated donor site morbidity as well as distraction of the surrounding soft tissue together with the transported bone. One of the major challenges when using alveolar distraction osteogenesis is controlling the vector of distraction, this problem should be further addressed in future researches. We describe different methods for alveolar distraction osteogenesis, including the surgical procedure, latency period, lengthening and consolidation period. We also discuss the advantages, disadvantages and complications of the method. In this manuscript a case of mandibular alveolar deficiency following mandibular fracture and loss of teeth and the alveolar bone is presented. This patient was treated by alveolar distraction osteogenesis with excellent results. This patient was later rehabilitated . using endosseous implants as demonstrated by radiographs. Alveolar distraction osteogenesis provides a method to regain both hard tissue and soft tissue without additional grafting and is an efficient modality in cases of medium to severe bone loss.

摘要

如今,种植体支持的修复在治疗方案中已变得非常普遍,但许多患者缺乏骨内种植体植入所需的垂直和水平骨量。牵张成骨是一种通过截骨术或皮质切开术后两个骨块的渐进性延长来生成骨组织的技术。牙槽嵴牵张成骨作为种植牙科的一种治疗方式,是一种非常有用的技术,可形成适合种植体植入的充足骨组织。牙槽嵴牵张可以是单向、双向、多向或水平的。牙槽嵴牵张成骨可通过使用骨内牵张装置、骨内牵张种植体或最常用的骨外装置来进行。牵张成骨有许多优点,如无需自体骨移植即可逐渐延长骨组织,不存在相关供区并发症,以及在骨组织移动的同时牵张周围软组织。使用牙槽嵴牵张成骨时的一个主要挑战是控制牵张向量,这个问题应在未来的研究中进一步探讨。我们描述了牙槽嵴牵张成骨的不同方法,包括手术步骤、延迟期、延长和巩固期。我们还讨论了该方法的优缺点及并发症。本文报告了一例下颌骨骨折并牙及牙槽骨缺失后下颌牙槽骨缺损的病例。该患者接受了牙槽嵴牵张成骨治疗,效果良好。该患者随后接受了修复,X线片显示使用了骨内种植体。牙槽嵴牵张成骨提供了一种无需额外植骨即可恢复硬组织和软组织的方法,是中重度骨量丢失病例中的一种有效治疗方式。

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