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皮质板技术:一种使用引导骨再生进行侧方牙槽嵴增高的治疗方法。

Cortical lamina technique: A therapeutic approach for lateral ridge augmentation using guided bone regeneration.

作者信息

Deepika-Penmetsa Shree-Lakshmi, Thomas Raison, Baron Tarun-Kumar, Shah Rucha, Mehta Dhoom-Singh

机构信息

BDS, Post Graduate Resident, Department of Periodontics, Bapuji Dental College & Hospital, Davangere- 577004, Karnataka, India.

MDS, Professor, Department of Periodontics, Bapuji Dental College & Hospital, Davangere- 577004, Karnataka, India.

出版信息

J Clin Exp Dent. 2017 Jan 1;9(1):e21-e26. doi: 10.4317/jced.53008. eCollection 2017 Jan.

Abstract

BACKGROUND

The present study aimed at evaluating the efficacy of a novel technique, the bone lamina technique, in horizontal ridge augmentation clinically & radiographically using a combination of allogenic cortical shell, particulate xenograft and resorbable collagen membrane.

MATERIAL AND METHODS

Localized horizontal ridge defects, in ten patients (6 male, 4 female), with bucco-palatal ridge width less than 5 mm were included in this study. Localised ridge augmentation was performed using bone lamina technique with mineralised allogenic shell of 1 mm thickness trimmed to the appropriate size using stereo-lithographic models and fixed to the recipient site with stainless steel micro-screws of 1 mm diameter. The space between the shell & host bone was filled with particulate xenograft followed by placement of collagen membrane and primary closure of the site. Clinical parameters including ridge width before & after flap reflection & radiographic (CBCT) ridge width measurements were recorded pre-operatively,and six months after the augmentation procedure. Results obtained were analysed statistically.

RESULTS

The mean clinical ridge width before flap reflection (BFR), after flap reflection (AFR) & radiographically was 3.7 ± 0.74 mm, 2 ± 0.70 mm & 1.77 ± 0.71 mm respectively at baseline which increased to 6.8 ± 0.95 mm, 5.15 ± 0.98 mm & 4.90 ± 0.90 mm with a mean gain in ridge width of 3.1 ± 0.63 mm (< 0.005), 3.15 ± 0.63 mm (<0.005) & 3.13 ± 0.70 mm (< 0.005) respectively.

CONCLUSIONS

The present study demonstrates that bone lamina technique can be effective means of horizontal ridge augmentation and the use of mineralized allograft in combination with xenograft and collagen membrane leads to good amount of bone regeneration for subsequent implant placement. Dental implant, guided bone regeneration, horizontal ridge defect, ridge augmentation.

摘要

背景

本研究旨在通过临床和影像学方法,评估一种新技术——骨板技术,在使用同种异体皮质骨壳、颗粒状异种移植物和可吸收胶原膜联合应用时,对水平骨嵴增量的疗效。

材料与方法

本研究纳入了10例患者(6例男性,4例女性),其颊腭侧骨嵴宽度小于5mm的局限性水平骨嵴缺损。采用骨板技术进行局限性骨嵴增量,使用通过立体光刻模型修整至合适尺寸的1mm厚矿化同种异体骨壳,并用1mm直径的不锈钢微螺钉固定于受体部位。骨壳与宿主骨之间的间隙用颗粒状异种移植物填充,随后放置胶原膜并对手术部位进行一期缝合。术前及骨增量手术后6个月记录临床参数,包括翻瓣前后的骨嵴宽度及影像学(CBCT)骨嵴宽度测量值。对所得结果进行统计学分析。

结果

基线时,翻瓣前(BFR)、翻瓣后(AFR)及影像学测量的平均临床骨嵴宽度分别为3.7±0.74mm、2±0.70mm及1.77±0.71mm,术后分别增加至6.8±0.95mm、5.15±0.98mm及4.90±0.90mm,骨嵴宽度平均增加量分别为3.1±0.63mm(<0.005)、3.15±0.63mm(<0.005)及3.13±0.70mm(<0.005)。

结论

本研究表明,骨板技术是水平骨嵴增量的有效方法,矿化同种异体骨与异种移植物及胶原膜联合应用可实现大量骨再生,为后续种植体植入创造条件。牙种植、引导骨再生、水平骨嵴缺损、骨嵴增量

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