Valdec Silvio, Pasic Pavla, Soltermann Alex, Thoma Daniel, Stadlinger Bernd, Rücker Martin
Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, University Hospital Zurich, Plattenstrasse 11, 8032, Zürich, Switzerland.
Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland.
Int J Implant Dent. 2017 Dec;3(1):12. doi: 10.1186/s40729-017-0071-9. Epub 2017 Mar 30.
Ridge preservation can be performed with autologous bone, alloplastic bone substitute material or a combination of both. Dentin is similar to bone in its chemical composition. In its use as bone substitute material, it undergoes a remodelling process and transforms to bone. The presented case report introduces a technique in which the extraction socket is augmented with autologous, particulated dentin.
The fractured, non-savable mesial incisor of the upper jaw was carefully extracted in axial direction. After the extraction, the tooth was cleared from remaining periodontal tissue. The vital pulp tissue or a root canal filling, enamel and cementum were also removed. Following the particulation of the remaining dentin in a bone mill, the dentin particles were immediately filled orthotope into the alveolar socket. The soft tissue closure was performed with a free gingival graft of the palate.
After an observation period of 4 months, an implant was placed in the augmented area, which osseointegrated successfully and could be restored prosthodontically in the following. The results of this method showed a functional and aesthetic success.
The pre-implantological, autologous ridge preservation with dentin could be performed successfully. For the establishment of dentin as augmentation material for jaw augmentation procedures, a prospective, clinical trial is now necessary.
牙槽嵴保存可使用自体骨、异体骨替代材料或两者结合来进行。牙本质在化学成分上与骨相似。在用作骨替代材料时,它会经历重塑过程并转化为骨。本病例报告介绍了一种用自体颗粒状牙本质增加拔牙窝骨量的技术。
小心地沿轴向拔除上颌已折断且无法保留的近中切牙。拔牙后,清除牙齿上残留的牙周组织。去除活髓组织或根管充填物、牙釉质和牙骨质。在骨磨中对剩余牙本质进行颗粒化处理后,立即将牙本质颗粒原位填入牙槽窝。用腭部游离龈瓣进行软组织关闭。
经过4个月的观察期后,在增加骨量的区域植入种植体,种植体成功实现骨整合,并在随后进行了义齿修复。该方法的结果显示出功能和美学上的成功。
牙本质用于种植前自体牙槽嵴保存能够成功实施。为了确立牙本质作为颌骨增量手术的填充材料,目前有必要开展一项前瞻性临床试验。