Department of Biomedicine and Neuromotor Sciences, Dental Clinic, Alma Mater Studiorum University of Bologna, Bologna, Italy.
J Periodontol. 2016 May;87(5):519-28. doi: 10.1902/jop.2016.150432. Epub 2016 Jan 12.
This study evaluates implant-borne prosthetic rehabilitation of 10 totally edentulous atrophic maxillae after bone reconstruction with a titanium-mesh technique and particulate bone graft.
Ten atrophic maxillae were reconstructed with 19 titanium meshes and particulate autologous-heterologous bone. Maxillae were rehabilitated at least 5 months, with placement of 67 implants connected to the prostheses after an additional 4 months of rehabilitation. Cases were evaluated retrospectively in terms of complication rates, particularly on the amount of mesh exposure, implant survival, and success rates at the end of follow-up.
In seven cases, two meshes were prematurely exposed (within 4 to 6 weeks), and five were exposed later (after 4 to 6 weeks). Only two of the later exposures extended >1 cm(2). Nevertheless, reconstructions allowed implant placement and prosthetic rehabilitation in all cases. Two implants were lost before loading. After mean follow-up at 39.3 (20 to 56) months since prosthetic loading, all 65 implants were functional (100% implant survival), but 15 implants demonstrated a peri-implant mean bone resorption of 2.96 mm increased bone loss, yielding a cumulative implant success rate of 76.9%. No prosthetic problem was observed.
Use of titanium mesh with particulate bone can be considered a valid option in reconstructing atrophic maxillae to allow for implant-borne prosthetic rehabilitation. A high level of dehiscence did not compromise final outcome.
本研究评估了在使用钛网技术和颗粒状自体-异种骨移植进行骨重建后,对 10 例全口无牙萎缩上颌骨进行种植体支持式修复的效果。
使用 19 个钛网和颗粒状自体-异种骨对 10 例萎缩上颌骨进行重建。上颌骨在接受修复后至少 5 个月,在另外 4 个月的修复后,将 67 个种植体连接到修复体上。通过并发症发生率,特别是钛网暴露量、种植体存活率和随访结束时的成功率,对病例进行回顾性评估。
在 7 例中,有 2 个网过早暴露(4 至 6 周内),5 个网后期暴露(4 至 6 周后)。只有 2 个后期暴露超过 1cm²。尽管如此,重建仍允许在所有病例中放置种植体和进行修复。在负重前有 2 个种植体丢失。在修复负重后平均随访 39.3(20 至 56)个月后,所有 65 个种植体均功能正常(100%种植体存活率),但 15 个种植体显示出 2.96mm 的平均骨吸收(增加的骨丢失),累积种植体成功率为 76.9%。未观察到任何修复体问题。
使用钛网和颗粒状骨可以被认为是一种有效的方法,用于重建萎缩的上颌骨,以实现种植体支持式修复。高水平的骨切开术并不影响最终结果。