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使用松质骨块同种异体移植物重建萎缩牙槽嵴后与年龄相关的新骨形成。

Age-related new bone formation following the use of cancellous bone-block allografts for reconstruction of atrophic alveolar ridges.

机构信息

Department of Oral Rehabilitation, School of Dental Medicine, Tel Aviv University, Tel-Aviv, Israel.

Department of Periodontology, School of Dental Medicine, Tel Aviv University, Tel-Aviv, Israel.

出版信息

Clin Implant Dent Relat Res. 2018 Feb;20(1):4-8. doi: 10.1111/cid.12560. Epub 2017 Dec 1.

Abstract

BACKGROUND

An age-related decrease in the number of osteogenic progenitor cells may compromise bone augmentation.

PURPOSE

Histomorphometrical assessment of age-related new bone formation, following atrophic alveolar ridge reconstruction, using cancellous bone-block allografts.

MATERIAL AND METHODS

Ninety-three consecutive patients (58 females and 35 males) were referred for implant-supported restoration of 122 severe atrophic alveolar ridges. Alveolar ridge deficiency locations were classified as anterior maxilla (n = 58), posterior maxilla (n= 32), and posterior mandible (n = 32). A bony deficiency of at least 3 mm horizontally and up to 3 mm vertically according to computerized tomography (CT) in the posterior mandible and anterior maxilla, served as inclusion criteria. In the posterior maxilla, a residual alveolar ridge up to 4 mm vertically according to CT served as inclusion criteria. Augmentation was performed by the use of cancellous bone-block allografts. Bone biopsies (9-month posterior maxilla, 4 months anterior maxilla and posterior mandible) of young (≤40 years) versus older (>40 years) patients were histomorphometrically evaluated.

RESULTS

In the posterior maxilla, no statistically significant histomorphometric differences were noted. While at the anterior maxilla and posterior mandible, statistically significant more newly formed bone was found in young versus older individuals, respectively (38.6% vs 19.8%, P = 0.04 and 69% vs 31%, P = .05).

CONCLUSION

New bone formation following residual alveolar ridge bone grafting is age-related. Longer bone consolidation and healing time may be recommended for older individuals.

摘要

背景

成骨祖细胞数量随年龄增长而减少,可能会影响骨增量。

目的

使用松质骨块同种异体移植物,评估与年龄相关的新骨形成,对萎缩牙槽嵴进行重建。

材料和方法

93 例连续患者(58 名女性和 35 名男性)因 122 例严重萎缩牙槽嵴需要植入物支持修复而被转诊。牙槽嵴缺损部位分为上颌前区(n=58)、上颌后区(n=32)和下颌后区(n=32)。根据计算机断层扫描(CT),下颌后区和上颌前区的骨缺损水平至少为 3 毫米,垂直方向至少为 3 毫米,作为纳入标准。上颌后区,根据 CT 标准,剩余牙槽嵴垂直方向可达 4 毫米作为纳入标准。使用松质骨块同种异体移植物进行增强。对年轻(≤40 岁)和老年(>40 岁)患者的 9 个月后的上颌后区、4 个月后的上颌前区和下颌后区的骨活检标本进行组织形态计量学评估。

结果

在上颌后区,未发现统计学上有显著差异的组织形态计量学差异。然而,在上颌前区和下颌后区,年轻患者的新骨形成明显多于老年患者(分别为 38.6%比 19.8%,P=0.04 和 69%比 31%,P=0.05)。

结论

残留牙槽嵴骨移植后的新骨形成与年龄有关。对于老年人,可能需要更长的骨整合和愈合时间。

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