Kakar Ashish, Kakar Kanupriya, Sripathi Rao Bappanadu H, Lindner Annette, Nagursky Heiner, Jain Gaurav, Patney Aditya
1Yenepoya University Dental College, University Road, Mangalore, 575018 India.
4Dental Surgery, Indraprastha Apollo Hospitals, New Delhi, India.
Maxillofac Plast Reconstr Surg. 2018 Feb 25;40(1):3. doi: 10.1186/s40902-018-0142-8. eCollection 2018 Dec.
In this research article, we evaluate the use of sub-periosteal tunneling (tunnel technique) combined with alloplastic in situ hardening biphasic calcium phosphate (BCP, a compound of β-tricalcium phosphate and hydroxyapatite) bone graft for lateral augmentation of a deficient alveolar ridge.
A total of 9 patients with deficient mandibular alveolar ridges were included in the present pilot study. Ten lateral ridge augmentation were carried out using the sub-periosteal tunneling technique, including a bilateral procedure in one patient. The increase in ridge width was assessed using CBCT evaluation of the ridge preoperatively and at 4 months postoperatively. Histological assessment of the quality of bone formation was also carried out with bone cores obtained at the implant placement re-entry in one patient.
The mean bucco-lingual ridge width increased in average from 4.17 ± 0.99 mm to 8.56 ± 1.93 mm after lateral bone augmentation with easy-graft CRYSTAL using the tunneling technique. The gain in ridge width was statistically highly significant ( = 0.0019). Histomorphometric assessment of two bone cores obtained at the time of implant placement from one patient revealed 27.6% new bone and an overall mineralized fraction of 72.3% in the grafted area 4 months after the bone grafting was carried out.
Within the limits of this pilot study, it can be concluded that sub-periosteal tunneling technique using in situ hardening biphasic calcium phosphate is a valuable option for lateral ridge augmentation to allow implant placement in deficient alveolar ridges. Further prospective randomized clinical trials will be necessary to assess its performance in comparison to conventional ridge augmentation procedures.
在本研究文章中，我们评估了骨膜下隧道技术（隧道技术）联合异体原位硬化双相磷酸钙（BCP，β-磷酸三钙与羟基磷灰石的复合物）骨移植用于牙槽嵴缺损侧方增高的效果。
本初步研究共纳入9例下颌牙槽嵴缺损患者。采用骨膜下隧道技术进行了10次牙槽嵴侧方增高术，其中1例患者为双侧手术。术前及术后4个月通过CBCT评估牙槽嵴宽度增加情况。还对1例患者在种植体植入再次切开时获取的骨芯进行了骨形成质量的组织学评估。
使用隧道技术采用易植CRYSTAL进行侧方骨增高后，颊舌向牙槽嵴平均宽度从4.17±0.99mm增加至8.56±1.93mm。牙槽嵴宽度的增加在统计学上具有高度显著性（P = 0.0019）。对1例患者种植体植入时获取的两个骨芯进行组织形态计量学评估显示，骨移植术后4个月，移植区域新骨占27.6%，矿化部分总体占72.3%。
在本初步研究的范围内，可以得出结论，使用原位硬化双相磷酸钙的骨膜下隧道技术是牙槽嵴缺损侧方增高以允许在牙槽嵴缺损处植入种植体的一种有价值的选择。与传统牙槽嵴增高手术相比，有必要进行进一步的前瞻性随机临床试验来评估其性能。
