Esposito Marco, Trullenque-Eriksson Anna, Vila Carlos Navarro, Peñarrocha Miguel, García Abel, Sánchez Arturo, Muñoz-Guzón Fernando, Martínez Martín José Manuel
Int J Oral Maxillofac Implants. 2017 Jul/Aug;32(4):838-848. doi: 10.11607/jomi.5824.
To evaluate in dogs a newly developed intraosseous alveolar distractor (Mozo-Grau Alveolar Distractor) for vertical bone augmentation to allow placement of dental implants.
Four dogs had their posterior teeth removed, and sockets were left to heal for 20 weeks. The right and left sides of the posterior mandibles were randomly allocated, according to a split-mouth design, to receive either two distractors, distracting a 32-mm-long bone segment, or two distractors supporting one bony segment 20 mm long and one 8 mm long. Each side of the jaw was treated by a different operator. Eight days after placement, distractors were activated with one complete turn (corresponding to 0.75 mm of vertical distraction) per day for 8 days, followed by a latency period of 10 weeks. Distractors were removed, and seven dental implants of two randomly allocated designs were placed in each dog. Implants were submerged for 2 months, and the dogs were sacrificed. Outcome measures were: success of the augmentation procedure (defined as a vertical gain of at least 5 mm of bone), any complications, implant failure, bone-to-implant contact (BIC), and peri-implant marginal bone level changes.
One dog was withdrawn because of a mandible fracture. Eight complications occurred, and six osseodistractors were lost, but no implant failed. Only two segments in one dog achieved a vertical bone gain of at least 5 mm. The mean radiographic vertical bone gain was 2.28 mm, whereas the mean histologic vertical bone gain was 3.16 mm. Histologically, all the implants were osseointegrated. The mean BIC for implants placed in new distracted bone was 34.78% ± 11.60% and 35.66% ± 8.84% for those placed in native bone. The mean peri-implant marginal bone level loss was 0.56 ± 0.54 mm.
It is possible to achieve vertical augmentation using intraosseous alveolar distractors to allow successful implantation of dental implants; however, the technique still requires surgical refinements and a dedicated training of the surgeons before being applied to humans.
在犬类中评估一种新开发的用于垂直骨增量以允许植入牙种植体的骨内牙槽撑开器（莫佐 - 格劳牙槽撑开器）。
4只犬的后牙被拔除，牙槽窝愈合20周。根据双侧对照设计，将后下颌骨的左右两侧随机分配，一侧接受两个撑开器，撑开一段32毫米长的骨段，另一侧接受两个撑开器，支撑一段20毫米长和一段8毫米长的骨段。颌骨的每一侧由不同的操作者进行处理。放置撑开器8天后，每天旋转一整圈（相当于垂直撑开0.75毫米），持续8天，随后有10周的延迟期。取出撑开器，在每只犬中植入7颗随机分配的两种设计的牙种植体。种植体埋植2个月后，处死犬只。观察指标包括：骨增量手术的成功率（定义为垂直骨增量至少5毫米）、任何并发症、种植体失败情况、骨与种植体接触率（BIC）以及种植体周围边缘骨水平变化。
1只犬因下颌骨骨折退出研究。发生了8例并发症，6个骨撑开器丢失，但没有种植体失败。只有1只犬的两个骨段实现了至少5毫米的垂直骨增量。影像学上平均垂直骨增量为2.28毫米，而组织学上平均垂直骨增量为3.16毫米。组织学检查显示，所有种植体均实现骨整合。植入新撑开骨中的种植体平均BIC为34.78%±11.60%，植入天然骨中的种植体平均BIC为35.66%±8.84%。种植体周围边缘骨水平平均丧失0.56±0.54毫米。
使用骨内牙槽撑开器实现垂直骨增量从而成功植入牙种植体是可行的；然而，在应用于人类之前，该技术仍需要手术改进以及外科医生进行专门培训。
