Khojasteh Arash, Nazeman Pantea, Tolstunov Len
Department of Oral and Maxillofacial Surgery, Director of basic science research, Dental research center, Research Institute of Dental Sciences, Dental school, Shahid Beheshti University of Medical Sciences, Tehran-Iran; PhD Candidate, School of Medicine, University of Antwerp (UA), Belgium.
Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran-Iran.
Br J Oral Maxillofac Surg. 2016 Oct;54(8):950-955. doi: 10.1016/j.bjoms.2016.06.018. Epub 2016 Jul 22.
Bone from the maxillary tuberosity has been harvested in particulate form to use for augmentation for several years, but block grafts have not been extensively used. A considerable advantage of a particulate bone graft from the maxillary tuberosity over those from other intraoral donor sites is the relative simplicity of harvesting and minimal complications. We have retrospectively assessed the efficacy of tuberosity-alveolar block bone (posterior maxillary alveolar ridge) in the augmentation of adjacent defects in the maxilla using data from 14 patients (10 men and four women, mean (range) age 55 (38-69) years) who had had 20 bony augmentations with block bone from the alveolar tuberosity during 2014. Patients were divided into three groups according to the technique by which the bone was collected. The first group had a graft from the alveolar tuberosity covered with titanium mesh (titanium mesh group); the second group had the block bone covered by platelet rich fibrin and collagen membrane (platelet rich fibrin group), and in the third group the graft was covered only with periosteum (periosteum group). The primary width of the bone was recorded at the time of placement of the graft and changes were evaluated 4-6 months later when the implant was inserted. The changes in the width of the bone were 4.1, 3.3, and 2.5 in the platelet rich fibrin, titanium mesh, and periosteum groups, respectively. The difference in bony change among groups was not significant except between the platelet rich fibrin and and periosteum groups (p=0.005). Tuberosity-alveolar block bone graft may be a good source of bone for augmentation of deficient ridges, and more favourable results can be expected by the addition of resorbable membranes and growth factors.
多年来，上颌结节的骨已被采集为颗粒形式用于骨增量，但块状移植尚未得到广泛应用。与来自其他口腔内供区的颗粒骨移植相比，上颌结节颗粒骨移植的一个显著优势是采集相对简单且并发症极少。我们回顾性评估了上颌结节 - 牙槽嵴块状骨（上颌后牙槽嵴）在增加上颌相邻缺损骨量方面的疗效，使用了2014年期间14例患者（10名男性和4名女性，平均（范围）年龄55（38 - 69）岁）的数据，这些患者接受了20次使用牙槽嵴结节块状骨的骨增量手术。根据采集骨的技术将患者分为三组。第一组接受覆盖钛网的牙槽嵴结节移植骨（钛网组）；第二组接受富含血小板纤维蛋白和胶原膜覆盖的块状骨（富含血小板纤维蛋白组），第三组移植骨仅覆盖骨膜（骨膜组）。在植入移植骨时记录骨的初始宽度，并在4 - 6个月后植入种植体时评估变化。富含血小板纤维蛋白组、钛网组和骨膜组的骨宽度变化分别为4.1、3.3和2.5。除富含血小板纤维蛋白组和骨膜组之间外，各组间骨变化的差异不显著（p = 0.005）。上颌结节 - 牙槽嵴块状骨移植可能是增加骨量不足牙槽嵴的良好骨源，通过添加可吸收膜和生长因子可预期获得更理想的结果。
