Hussein Laith A, Hassan Thair A L
Department of Oral and Maxillofacial Surgery, Dental Teaching Hospital, College of Dentistry, University of Baghdad, Bab-Almoadham, Baghdad, Iraq.
J Craniofac Surg. 2017 Oct;28(7):1766-1771. doi: 10.1097/SCS.0000000000003943.
The posterior maxilla is challenged with postextraction alveolar bone resorption and pneumatization drive of the Schneiderian membrane that reduces the subantral distance. To overcome such anatomic obstacle a sinus augmentation procedure was introduced either via lateral or crestal approach depending on residual ridge height. The current study evaluated oxidized regenerated cellulose (ORC) as a grafting material versus osteon II by measuring bone gain and graft density, 24 weeks postoperatively. Twenty consecutive patients (24 cases) aged from 20 to 65 years were considered eligible after clinical and radiographic evaluation. These patients were allocated in 2 groups (study and control) that underwent transcrestal osteotome antral membrane balloon elevation and surgical void augmentation with ORC in the study group, while the control group grafted with collagen membrane and osteon II with simultaneous dental implant placement in both groups and were followed up for 1 year. Cone beam computed tomography was taken for all patients preoperatively and postoperatively to verify neoformed bone and density in Hounsfield units (HU). The mean gained height of the bone was 6.48 mm (5.94 mm in the study and 7.02 mm in the control). The mean density of graft above implant apex was 497.99 HU (434.23 HU in the study and 561.75 HU in the control). Apart from Schneider membrane thickening in 2 patients from the control group, there were no serious complications reported throughout the study. These results demonstrate that ORC is a reasonable grafting material with comparable outcomes when compared to osteon II with less postoperative complications.
上颌骨后部面临拔牙后牙槽骨吸收以及上颌窦黏膜气化的挑战，这会减小窦下间隙。为克服这一解剖学障碍，根据剩余牙槽嵴高度，通过外侧或嵴顶入路引入了窦底提升术。本研究在术后24周通过测量骨增量和植骨密度，评估氧化再生纤维素（ORC）作为一种植骨材料与Osteon II相比的效果。经过临床和影像学评估，20例年龄在20至65岁之间的连续患者（24例）被认为符合条件。这些患者被分为两组（研究组和对照组），研究组接受经嵴顶骨凿上颌窦黏膜球囊提升术并用ORC进行手术腔隙植骨，而对照组植入胶原膜和Osteon II，两组均同时植入牙种植体，并随访1年。对所有患者在术前和术后进行锥形束计算机断层扫描，以验证新形成的骨以及以亨氏单位（HU）表示的密度。骨的平均增高为6.48毫米（研究组为5.94毫米，对照组为7.02毫米）。种植体根尖上方植骨的平均密度为497.99 HU（研究组为434.23 HU，对照组为561.75 HU）。除对照组有2例患者出现上颌窦黏膜增厚外，在整个研究过程中未报告严重并发症。这些结果表明，与Osteon II相比，ORC是一种合理的植骨材料，效果相当，且术后并发症更少。
