Ahmadi Roya Shariatmadar, Sayar Ferena, Rakhshan Vahid, Iranpour Babak, Jahanbani Jahanfar, Toumaj Ahmad, Akhoondi Nasrin
1 Department of Periodontics and Implant Research, Tehran Dental Branch, Islamic Azad University, Tehran, Iran.
2 Department of Dental Anatomy, Dental Faculty, Islamic Azad University, Tehran, Iran.
J Oral Implantol. 2017 Jun;43(3):202-210. doi: 10.1563/aaid-joi-D-16-00042. Epub 2017 Mar 22.
Horizontal ridge augmentation with allografts has attracted notable attention because of its proper success rate and the lack of disadvantages of autografts. Corticocancellous block allografts have not been adequately studied in humans. Therefore, this study clinically and histomorphometrically evaluated the increase in ridge width after horizontal ridge augmentation using corticocancellous block allografts as well as implant success after 12 to 18 months after implantation. In 10 patients receiving implants (3 women, 7 men; mean age = 45 years), defective maxillary alveolar ridges were horizontally augmented using freeze-dried bone allograft blocks. Ridge widths were measured before augmentation, immediately after augmentation, and ∼6 months later in the reentry surgery for implantation. This was done at points 2 mm (A) and 5 mm (B) apically to the crest. Biopsy cores were acquired from the implantation site. Implant success was assessed 15.1 ± 2.7 months after implantation (range = 12-18 months). Data were analyzed using Friedman and Dunn tests (α = 0.05). At point A, ridge widths were 2.77 ± 0.37, 8.02 ± 0.87, and 6.40 ± 0.66 mm, respectively, before surgery, immediately after surgery, and before implantation. At point B, ridge widths were 3.40 ± 0.39, 9.35 ± 1.16, and 7.40 ± 1.10 mm, respectively, before surgery, immediately after surgery, and before implantation. The Friedman test showed significant increases in ridge widths, both at point A and point B (both P = .0000). Postaugmentation resorption was about 1.5-2 mm and was statistically significant at points A and B (P < .05, Dunn). The percentage of newly formed bone, residual graft material, and soft tissue were 33.0% ± 11.35% (95% confidence interval [CI] = 24.88%-41.12%), 37.50% ± 19.04% (95% CI = 23.88%-51.12%), and 29.5%, respectively. The inflammation was limited to grades 1 or zero. Twelve to 18 months after implantation, no implants caused pain or showed exudates or pockets. Radiographic bone loss was 2.0 ± 0.7 mm (range = 1-3). It can be concluded that lateral ridge augmentation with corticocancellous allograft blocks might be successful both clinically and histologically. Implants might have a proper clinical success after a minimum of 12 months.
同种异体皮质松质骨块进行水平牙槽嵴增高术因其成功率适宜且无自体骨移植的缺点而备受关注。皮质松质骨块在人体中的研究尚不充分。因此，本研究从临床和组织形态计量学方面评估了使用皮质松质骨块进行水平牙槽嵴增高术后牙槽嵴宽度的增加情况以及植入12至18个月后种植体的成功率。在10例接受种植体植入的患者（3名女性，7名男性；平均年龄 = 45岁）中，使用冻干同种异体骨块对有缺陷的上颌牙槽嵴进行水平增高。在增高术前、增高术后即刻以及在植入再入手术时约6个月后，在距牙槽嵴顶根尖2 mm（A点）和5 mm（B点）处测量牙槽嵴宽度。从植入部位获取活检组织芯。在植入后15.1 ± 2.7个月（范围 = 12 - 18个月）评估种植体成功率。使用Friedman检验和Dunn检验（α = 0.05）分析数据。在A点，手术前、手术后即刻和植入前牙槽嵴宽度分别为2.77 ± 0.37、8.02 ± 0.87和6.40 ± 0.66 mm。在B点，手术前、手术后即刻和植入前牙槽嵴宽度分别为3.40 ± 0.39、9.35 ± 1.16和7.40 ± 1.10 mm。Friedman检验显示A点和B点的牙槽嵴宽度均有显著增加（P均 = 0.0000）。增高术后吸收约为1.5 - 2 mm，在A点和B点具有统计学意义（P < 0.05，Dunn检验）。新形成骨、残余移植材料和软组织的百分比分别为33.0% ± 11.35%（95%置信区间[CI] = 24.88% - 41.12%）、37.50% ± 19.04%（95% CI = 23.88% - 51.12%）和29.5%。炎症仅限于1级或0级。植入后12至18个月，无种植体引起疼痛或出现渗出物或牙周袋。影像学骨吸收为2.0 ± 0.7 mm（范围 = 1 - 3）。可以得出结论：使用皮质松质骨块进行侧方牙槽嵴增高术在临床和组织学上可能是成功的。种植体至少在12个月后可能具有良好的临床成功率。
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