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用于牙槽嵴重建的骨移植。166例病例回顾。

Bone grafting for alveolar ridge reconstruction. Review of 166 cases.

作者信息

Salmen Fued Samir, Oliveira Marina Reis, Gabrielli Marisa Aparecida Cabrini, Piveta Ana Cláudia Gabrielli, Pereira Valfrido Antonio, Gabrielli Mario Francisco Real

机构信息

- Araraquara Dental School, São Paulo State University (UNESP), Oral and Maxillofacial Surgery, Department of Diagnosis and Surgery, Araraquara, Sao Paulo State, Brazil.

出版信息

Rev Col Bras Cir. 2017 Jan-Feb;44(1):33-40. doi: 10.1590/0100-69912017001004.

DOI:10.1590/0100-69912017001004
PMID:28489209
Abstract

OBJECTIVE

: to investigate the predictive factors of failure in bone grafts for alveolar ridge augmentation and implant surgery.

METHODS

: we reviewed the charts of 166 patients operated between 1995 and 2014. A total of 248 grafting procedures were performed. We submitted the data to the binomial test at 5% significance.

RESULTS

: grafts to gain width of the alveolar ridge (65.32%) were more frequent than sinus lifting (p<0.0001) and the number of grafts to the posterior maxilla (48.8%) was greater than in other regions (p<0.01); 6.04% of the grafts were lost. The losses in anterior (p<0.0309) and posterior (p<0.0132) maxilla were higher than in the mandible. There were 269 ​​implants installed in the grafted areas, of which only 4.83% were lost. The number of implants lost (4.51%) in areas of onlay grafts was not statistically higher than those placed after sinus lifting (2.63%, p<0.2424). Losses were greater in the anterior (53.85%) and posterior (38.46%) maxilla than in the mandible (p<0.031). Regarding patients' age, 76.92% of the lost grafts (p<0.006) and 80% of the lost implants (p<0.001) were installed in patients over 40 years.

CONCLUSION

: failure rate was higher both for grafts and dental implants in the maxilla and in patients over 40 years of age.

OBJETIVO

: investigar os fatores preditivos de falhas em enxertos ósseos para aumento do rebordo alveolar e cirurgia de implantes.

MÉTODOS:: os prontuários de 166 pacientes, operados entre 1995 e 2014, foram revistos. Um total de 248 enxertos foi realizado. Os dados foram submetidos ao teste binomial a 5% de significância.

RESULTADOS

: os enxertos para ganho em espessura do rebordo alveolar (65,32%) foram mais frequentes do que levantamentos de seio maxilar (p<0,0001) e o número de enxertos para a região posterior da maxila (48,8%) foi maior do que em outras regiões (p<0,01). Foram perdidos 6,04% dos enxertos. As perdas em maxila anterior (p<0,0132) e posterior (p<0,0309) foram maiores do que na mandíbula. Foram instalados 269 implantes nas áreas enxertadas e apenas 4,83% perdidos. O número de implantes perdidos (4,51%) em áreas de enxertos em bloco não foi estatisticamente maior do que na área de seios maxilares enxertados (2,63%) (p<0,2424). As perdas foram maiores na região anterior (53,85%) e posterior (38,46%) da maxila em relação a mandíbula (p<0,031) e, 76,92% dos enxertos (p<0,006) e 80% dos implantes perdidos (p<0,001), foram instalados em pacientes com mais de 40 anos de idade.

CONCLUSÃO:: maior taxa de falhas foi observada para enxertos e implantes dentários realizados em maxila e em pacientes com mais de 40 anos de idade.

摘要

目的

探讨牙槽嵴增高及种植手术中骨移植失败的预测因素。

方法

回顾1995年至2014年间166例患者的病历。共进行了248次移植手术。我们将数据进行二项式检验,显著性水平为5%。

结果

增加牙槽嵴宽度的移植手术(65.32%)比上颌窦提升术更常见(p<0.0001),上颌后部的移植手术数量(48.8%)多于其他区域(p<0.01);6.04%的移植手术失败。上颌前部(p<0.0309)和后部(p<0.0132)的失败率高于下颌。在移植区域共植入269颗种植体,其中仅4.83%丢失。覆盖式骨移植区域种植体的丢失率(4.51%)在统计学上并不高于上颌窦提升术后植入的种植体(2.63%,p<0.2424)。上颌前部(53.85%)和后部(38.46%)的种植体丢失率高于下颌(p<0.031)。关于患者年龄,76.92%的失败移植手术(p<0.006)和80%的失败种植体(p<0.001)是在40岁以上患者中植入的。

结论

上颌骨及40岁以上患者的骨移植和牙种植失败率更高。

目的

研究用于牙槽嵴增高和种植手术的骨移植失败的预测因素。

方法

查阅166例在1995年至2014年间接受手术患者的病历。共进行了总计248次骨移植。数据进行显著性水平为5%的二项式检验。

结果

用于增加牙槽嵴宽度的骨移植(65.32%)比上颌窦提升术更频繁(p<0.0001),上颌后部的骨移植数量(48.8%)多于其他区域(p<0.01);6.04%的骨移植失败。上颌前部(p<0.0132)和后部(p<0.0309)的失败率高于下颌。在骨移植区域植入了269颗种植体,仅有4.83%丢失。块状骨移植区域丢失的种植体数量(4.51%)在统计学上并不高于上颌窦提升骨移植区域(2.63%)(p<0.2424)。上颌前部(53.85%)和后部(38.46%)的种植体丢失率高于下颌(p<0.031),76.92%的失败骨移植(p<0.006)和8丢失的种植体中有80%(p<0.001)是在40岁以上患者中植入的。

结论

在上颌骨以及40岁以上患者中进行的骨移植和牙种植手术失败率更高。

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