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在上颌前牙区引导骨组织再生愈合阶段硬组织体积稳定性的临床和放射学研究。

Hard tissue volume stability of guided bone regeneration during the healing stage in the anterior maxilla: A clinical and radiographic study.

机构信息

Department of Oral Implantology, Peking University School and Hospital of Stomatology, Beijing, P.R. China.

出版信息

Clin Implant Dent Relat Res. 2018 Feb;20(1):68-75. doi: 10.1111/cid.12570. Epub 2017 Dec 28.

Abstract

BACKGROUND

Guided bone regeneration (GBR) is currently the most widely used technique to reconstruct localized peri-implant bone defects.

OBJECTIVES

To evaluate hard tissue volume stability during the healing stage of GBR with particulate bone graft and resorbable collagen membrane.

MATERIALS AND METHODS

Twenty-eight patients who were missing a single maxillary incisor and required implant placement combined with GBR were randomly assigned to 2 groups: submerged (n = 14) and transmucosal (n = 14) healing groups. Cone-beam computed tomography (CBCT) was performed before, immediately after and 6 months post-surgery. The 3 sets of CBCT data were three-dimensionally reconstructed and superimposed. Horizontal hard tissue alterations at different vertical levels were recorded. The relative position and distances from the boundary line of the bony defect envelope to the outlines of the augmented ridge were determined immediately post-augmentation and 6 months after healing.

RESULTS

Augmented ridge underwent horizontal volume reduction during the healing period. Vertical levels (P = .000) rather than healing strategies (submerged or transmucosal) (P = .182) had statistically significant impacts on the reduction width. The boundary line of the ridge defect envelope located within the bony profile immediately after surgery, but outside of the bony profile after 6 months.

CONCLUSIONS

GBR with resorbable membrane and particulate bovine bone would undergo horizontal volume reduction during the healing stage. New bone formation at the coronal site may only be predictable within the bony envelope.

摘要

背景

引导骨再生(GBR)是目前最广泛用于重建局部种植体周围骨缺损的技术。

目的

评估颗粒状骨移植物和可吸收胶原膜引导骨再生愈合阶段的硬组织体积稳定性。

材料和方法

28 名上颌切牙缺失并需要植入物放置联合 GBR 的患者被随机分为 2 组:淹没组(n=14)和黏膜下组(n=14)。在术前、术后即刻和术后 6 个月进行锥形束 CT(CBCT)检查。对 3 组 CBCT 数据进行三维重建和叠加。记录不同垂直水平的水平硬组织变化。在增强后即刻和愈合后 6 个月,确定骨缺损包络线的边界与增强嵴轮廓之间的相对位置和距离。

结果

在愈合期,增强嵴发生水平体积减少。垂直水平(P=0.000)而不是愈合策略(淹没或黏膜下)(P=0.182)对减少宽度有统计学显著影响。嵴缺损包络线的边界线在手术后即刻位于骨轮廓内,但在 6 个月后位于骨轮廓外。

结论

可吸收膜和颗粒牛骨引导骨再生在愈合阶段会发生水平体积减少。冠部新骨形成只能在骨包络内预测。

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