Jun Choong-Man, Yun Jeong-Ho
Int J Periodontics Restorative Dent. 2016 Jan-Feb;36(1):75-81. doi: 10.11607/prd.1950.
In this study, the effectiveness of a corticocancellous block allograft for restoring alveolar ridge defects in preparation for the placement of dental implants was assessed. Significant ridge defects in four partially edentulous patients were reconstructed using an irradiated corticocancellous allogeneic block soaked in platelet-rich plasma, which was also covered with a resorbable collagen membrane. After 5 or 6 months, the sites were reentered and a trephine bone core specimen was obtained from each augmented site for histologic, histomorphometric, and immunohistochemical assessment. In all four cases, histologic evaluation of the augmented site showed areas of new vital bone formation around the graft material (mean newly formed bone fraction, 23.7%; mean total mineralized tissue fraction, 40.1%), in which osteocytes were frequently observed within the lacunae. Immunohistochemical analysis showed the presence of biomarkers commonly related to active bone formation (alkaline phosphatase, osteocalcin, and bone morphogenetic protein-2), confirming that the biochemical environment was conducive to new bone formation. The findings of this study demonstrate that the use of allogeneic block grafts for restoring alveolar ridge defects prior to the placement of dental implants may be an effective and advantageous alternative to autograft procedures.
在本研究中,评估了皮质骨松质块状同种异体移植物在修复牙槽嵴缺损以准备植入牙种植体方面的有效性。使用浸泡在富血小板血浆中的辐照皮质骨松质同种异体块状物对4例部分牙列缺损患者的明显牙槽嵴缺损进行重建,该块状物还用可吸收胶原膜覆盖。5或6个月后,再次进入这些部位,从每个植骨部位获取环钻骨芯标本进行组织学、组织形态计量学和免疫组织化学评估。在所有4例病例中,植骨部位的组织学评估显示移植物材料周围有新的活性骨形成区域(平均新形成骨分数为23.7%;平均总矿化组织分数为40.1%),在这些区域的骨陷窝内经常观察到骨细胞。免疫组织化学分析显示存在通常与活跃骨形成相关的生物标志物(碱性磷酸酶、骨钙素和骨形态发生蛋白-2),证实生化环境有利于新骨形成。本研究结果表明,在植入牙种植体之前使用同种异体块状移植物修复牙槽嵴缺损可能是自体移植手术的一种有效且有利的替代方法。