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与其他形式的水平牙槽嵴增高术相比,帐篷螺钉杆技术的效果如何?

How Effective Is the Tent Screw Pole Technique Compared to Other Forms of Horizontal Ridge Augmentation?

作者信息

Deeb George R, Tran Dan, Carrico Caroline K, Block Erin, Laskin Daniel M, Deeb Janina Golob

机构信息

Associate Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Virginia Commonwealth University, Richmond, VA.

Resident, Department of Oral and Maxillofacial Surgery, School of Dentistry, Virginia Commonwealth University, Richmond, VA.

出版信息

J Oral Maxillofac Surg. 2017 Oct;75(10):2093-2098. doi: 10.1016/j.joms.2017.05.037. Epub 2017 Jun 13.

Abstract

PURPOSE

The tent screw pole technique is one of the methods available for practitioners to perform horizontal ridge augmentation to facilitate dental implant placement. The purpose of this study was to evaluate the efficacy of the tent screw pole technique for horizontal ridge augmentation and to compare the results with those of the tunnel technique and open ridge augmentation.

PATIENTS AND METHODS

In this retrospective cohort study, 35 patients underwent horizontal ridge augmentation with the tent screw pole technique, a 1:1 ratio of mineralized freeze-dried bone allograft and particulate bovine hydroxyapatite, and a resorbable collagen membrane. The incidence of early wound dehiscence and membrane exposure, the number of courses of antibiotics and postoperative visits required for their management, and the number of sites that subsequently had successful implant placement were recorded. These parameters were compared with those in 21 patients who had undergone horizontal ridge augmentation by the tunnel technique and 31 patients who had been treated using an open procedure and a resorbable polytetrafluoroethylene (PTFE) membrane in the authors' previous study (J Oral Maxillofac Surg 74:1752, 2016).

RESULTS

Implant placement rate was similar for all 3 methods (71 to 97%). However, there were significant differences among the 3 surgical techniques for membrane exposure and wound dehiscence (P = .0033), graft loss (P = .0256), courses of antibiotics (P = .0017), and postoperative visits (P = .0043). The PTFE method consistently had the highest rate of complications, whereas the tent screw and tunnel techniques were comparable.

CONCLUSIONS

All 3 techniques allowed a high rate of implant placement; however, the PTFE technique was consistently associated with increased postoperative complications compared with the other 2 methods. The tent screw technique might be more favorable than the tunnel technique in cases in which the bony deficiency is flat.

摘要

目的

帐篷螺钉杆技术是临床医生用于进行水平牙槽嵴增量以利于牙种植体植入的可用方法之一。本研究的目的是评估帐篷螺钉杆技术用于水平牙槽嵴增量的疗效,并将结果与隧道技术和开放式牙槽嵴增量的结果进行比较。

患者与方法

在这项回顾性队列研究中,35例患者采用帐篷螺钉杆技术进行水平牙槽嵴增量,使用矿化冻干同种异体骨与颗粒状牛羟基磷灰石按1:1比例混合,并使用可吸收胶原膜。记录早期伤口裂开和膜暴露的发生率、抗生素治疗疗程数及其处理所需的术后复诊次数,以及随后成功植入种植体的部位数量。将这些参数与作者之前研究(《口腔颌面外科杂志》74:1752,2016)中21例采用隧道技术进行水平牙槽嵴增量的患者以及31例采用开放式手术和可吸收聚四氟乙烯(PTFE)膜治疗的患者的参数进行比较。

结果

所有3种方法的种植体植入率相似(71%至97%)。然而,在膜暴露和伤口裂开(P = .0033)、植骨块丢失(P = .0256)、抗生素治疗疗程(P = .0017)和术后复诊(P = .0043)方面,3种手术技术之间存在显著差异。PTFE方法的并发症发生率始终最高,而帐篷螺钉技术和隧道技术相当。

结论

所有3种技术的种植体植入率都很高;然而,与其他2种方法相比,PTFE技术术后并发症持续增加。在骨缺损平坦的情况下,帐篷螺钉技术可能比隧道技术更具优势。

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