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异体骨移植在上颌骨和下颌骨重建中的安全性和临床疗效评估

Evaluation of the Safety and Clinical Efficacy of Allogeneic Bone Grafts in the Reconstruction of the Maxilla and Mandible.

作者信息

Stopa Z, Siewert-Gutowska M, Abed K, Szubińska-Lelonkiewicz D, Kamiński A, Fiedor P

机构信息

Department of Cranio-Maxillofacial Surgery, Oral Surgery and Implantology, Infant Jesus Teaching Hospital-Medical University of Warsaw, Warsaw, Poland.

Department of Cranio-Maxillofacial Surgery, Oral Surgery and Implantology, Infant Jesus Teaching Hospital-Medical University of Warsaw, Warsaw, Poland.

出版信息

Transplant Proc. 2018 Sep;50(7):2199-2201. doi: 10.1016/j.transproceed.2018.02.122. Epub 2018 Mar 14.

DOI:10.1016/j.transproceed.2018.02.122
PMID:30177136
Abstract

INTRODUCTION

Loss of teeth caused by inflammatory processes or trauma is one of the causes of bone atrophy of the maxilla alveolar process and the alveolar part of the mandible. Often, restoring these deficiencies with dental implants requires additional reconstructive procedures. Methods using autogenous, allogeneic, xenogeneic, or synthetic bone grafts are commonly used.

MATERIALS AND METHODS

Patients who had bone atrophy of the maxilla or mandible were qualified for deep-frozen transplantation, radiation-sterilized allogeneic bone from the Bank of Tissues in the form of cortico-spongy bone blocks and spongy bone granules. Bone blocks were stabilized with titanium screws, and the free spaces were additionally supplemented with chips from autogenous bone and covered with allogeneic pericardial transplants and platelet-rich fibrin (PRF). Four months after the bone reconstruction, titanium implants were placed, and then after the osseointegration period prosthetic restoration was performed. Clinical safety and efficacy were determined by analyzing the quantity and quality of the reconstructed bone tissue and the degree of resorption was assessed.

RESULTS

The surgical procedures performed confirmed the safety and efficacy of biological material in the reconstruction of the jaw. In two cases, the treatment was not effective and the transplant was removed. In the remaining cases, titanium implants were successfully placed and loaded with prosthetic works.

DISCUSSION

Implanting deeply frozen, radiation-sterilized bone is a safe and effective surgical procedure. As an appropriate technique for fixing the allogeneic bone block, additional use of autogenous bone chips and PRF allows one to obtain a good, long-lasting clinical result.

摘要

引言

由炎症过程或创伤导致的牙齿缺失是上颌牙槽突和下颌牙槽部分骨萎缩的原因之一。通常,使用牙种植体修复这些缺损需要额外的重建手术。常用的方法包括使用自体、异体、异种或合成骨移植材料。

材料与方法

上颌或下颌存在骨萎缩的患者符合接受深冻移植的条件,移植材料为来自组织库的经辐射灭菌的异体骨,呈皮质松质骨块和松质骨颗粒的形式。骨块用钛螺钉固定,剩余空间用自体骨碎片补充,并覆盖异体心包移植片和富血小板纤维蛋白(PRF)。骨重建四个月后植入钛种植体,然后在骨整合期后进行修复修复。通过分析重建骨组织的数量和质量来确定临床安全性和有效性,并评估吸收程度。

结果

所进行的手术证实了生物材料在颌骨重建中的安全性和有效性。有两例治疗无效,移植材料被移除。在其余病例中,钛种植体成功植入并安装了修复体。

讨论

植入深冻、辐射灭菌的骨是一种安全有效的手术方法。作为固定异体骨块的合适技术,额外使用自体骨碎片和PRF能够获得良好的长期临床效果。

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