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通过预制钛箔引导骨再生:一个病例系列的临床、组织学和组织形态计量学结果

Guided bone regeneration via a preformed titanium foil: clinical, histological and histomorphometric outcome of a case series.

作者信息

Andreasi Bassi M, Andrisani C, Lico S, Ormanier Z, Ottria L, Gargari M

机构信息

Private practice, Rome, Italy.

Private practice, Matera, Italy.

出版信息

Oral Implantol (Rome). 2016 Nov 16;9(4):164-174. doi: 10.11138/orl/2016.9.4.164. eCollection 2016 Oct-Dec.

Abstract

PURPOSE

The aim of this paper was to evaluate the histological and histomorphometric outcome of Preformed Titanium Foil (PTF) to perform Guided Bone Regeneration (GBR) in posterior mandibular atrophies.

MATERIALS AND METHODS

10 subjects (1 male; 9 females; mean age 58±11.37 years), with distal mandibular atrophies were selected to perform GBR by means of PTF, using a moldable allograft paste as graft material. The devices, made of a 0,2 mm thick pure titanium foil, were pre-shaped using stereolithographic models obtained from CT-scan of the patients' recipient site. In the second stage, performed at 6.7±2.33 months, 18 cylindrical two-piece implants were placed and the devices removed, at the same time bone biopsies were harvested. At 4 months, the implants were exposed and submitted to progressive prosthetic load for a span of 4 months. The cases were finalized by means of metal-ceramic cementable restorations. The post finalization follow-up was at 12 months.

RESULTS

Survival rate (i.e. SVR) was 100% since none fixtures were lost. At the one-year follow up the clinical appearance of the soft tissues was optimal and not pathological signs on probing were recorded. The success rate (i.e. SCR) was 88.2% and the average peri-implant bone reabsorption was 1.17±0.41 mm. The average rate of graft contraction was 19.4±10.55%. The mean percentage occupied by mineralized bone was 48.03±5.93%, while the bone marrow and graft material were 36.1±2.81% and 15.87±4.87 %, respectively.

CONCLUSION

The results suggest good potentialities of the method for GBR in distal mandibular atrophies, allowing to maximize the outcome and simplifying the surgical phase.

摘要

目的

本文旨在评估预制钛箔(PTF)在下颌后牙区骨萎缩中进行引导骨再生(GBR)的组织学和组织形态学结果。

材料与方法

选取10例(1例男性;9例女性;平均年龄58±11.37岁)下颌远端骨萎缩患者,采用PTF进行GBR,使用可塑形同种异体移植糊剂作为移植材料。这些装置由0.2毫米厚的纯钛箔制成,利用从患者受植部位的CT扫描获得的立体光刻模型进行预塑形。在第二阶段,于6.7±2.33个月时进行,植入18枚圆柱形两件式种植体并取出装置,同时采集骨活检样本。在4个月时,暴露种植体并进行为期4个月的渐进性修复加载。通过金属陶瓷粘结修复完成病例。最终完成后的随访时间为12个月。

结果

由于没有种植体丢失,存留率(即SVR)为100%。在一年的随访中,软组织的临床外观最佳,探诊未记录到病理体征。成功率(即SCR)为88.2%,种植体周围平均骨吸收为1.17±0.41毫米。移植材料平均收缩率为19.4±10.55%。矿化骨所占平均百分比为48.0%3±5.93%,而骨髓和移植材料分别为36.1±2.81%和15.87±4.87%。

结论

结果表明该方法在下颌远端骨萎缩的GBR中具有良好的潜力,能够使结果最大化并简化手术阶段。

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